7
Application for a club premises certificate to be granted under the Licensing Act 2003
PLEASE READ THE FOLLOWING INSTRUCTIONS BEFORE COMPLETING APPLICATION
Before completing this form please read the guidance notes at the end of the form.
If you are completing this form by hand please write legibly in block capitals. In all cases ensure that
your answers are inside the boxes and written in black ink. Use additional sheets if necessary.
You may wish to keep a copy of the completed form for your records.
(Insert name of club)
club applies for a club premises certificate under section 71 of the Licensing Act
2003 for the premises described in Part 1 below (the club premises).
The club is making this application to you as the relevant licensing authority in
accordance with section 68 of the Licensing Act 2003.
Part 1 Club premises details
Name of club
Postal address of premises or, if none, ordnance survey map reference or description
Post Town
Postcode
Telephone number (if any)
E-mail address (optional)
Name of person performing duties of a secretary to the club
Address of person performing duties of a secretary to the club
Post Town
Postcode
Daytime contact telephone
number (if any)
E-mail address (optional)
Non-domestic rateable value of
premises
£
8
Yes
No
Part 2 Club Operating Schedule
When do you want the club premises certificate to start?
DD
MM
YYYY
If you wish the certificate to be valid only for a limited
period, when do you want it to end?
DD
MM
YYYY
General description of club (please read guidance note 1)
If 5,000 or more people are expected to attend the
premises at any one time, please state the number
expected to attend:
What qualifying club activities do you intend to conduct on the club premises?
Provision of regulated entertainment (please read guidance note 2)
Please tick all
that apply
a)
plays (if ticking yes, fill in box A)
b)
films (if ticking yes, fill in box B)
c)
indoor sporting events (if ticking yes, fill in box C)
d)
boxing or wrestling entertainment (if ticking yes, fill in box D)
e)
live music (if ticking yes, fill in box E)
f)
recorded music (if ticking yes, fill in box F)
g)
performances of dance (if ticking yes, fill in box G)
h)
anything of a similar description to that falling within (e), (f) or (g) (if ticking yes,
fill in box H)
The supply of alcohol by or on behalf of a club to, or to the order of, a
member of the club (if ticking yes, fill in box I)
The sale by retail of alcohol by or on behalf of a club to a guest of a member
of the club for consumption on the premises where the sale takes place (if
ticking yes, fill in box J
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In all cases complete boxes K and L.
A
Plays
Standard days and
timings (please read
guidance note 7)
Will the performance of a play take place
indoors or outdoors or both please tick
(please read guidance note 3)
Indoors
Outdoors
Day
Start
Finish
Both
Mon
Please give further details here (please read guidance note 4)
Tue
Wed
State any seasonal variations for performing plays (please
read guidance note 5)
Thur
Fri
Non standard timings. Where the club intends to use the
premises for the performance of a play at different times
from those listed in the column on the left, please list
(please read guidance note 6)
Sat
Sun
B
Films
Standard days and
timings (please read
guidance note 7)
Will the exhibition of films take place
indoors or outdoors or both please tick
(please read guidance note 3)
Indoors
Outdoors
Day
Start
Finish
Both
Mon
Please give further details here (please read guidance note 4)
Tue
Wed
State any seasonal variations for the exhibition of films
(please read guidance note 5)
Thur
Fri
Non standard timings. Where you intend to use the
premises for the exhibition of films at different times to
those listed in the column on the left, please list (please
read guidance note 6)
Sat
Sun
C
Indoor sporting
events
Standard days and
timings (please read
guidance note 7)
Please give further details (please read guidance note 4)
Day
Start
Finish
Mon
Tue
State any seasonal variations for indoor sporting events
(please read guidance note 5)
Wed
Thur
Non standard timings. Where you intend to use the
premises for indoor sporting events at different times to
those listed in the column on the left, please list (please
read guidance note 6)
Fri
Sat
Sun
D
Boxing or wrestling
entertainments
Standard days and
timings (please read
guidance note 7)
Will the boxing or wrestling entertainment
take place indoors or outdoors or both
please tick (please read guidance note 3)
Indoors
Outdoors
Day
Start
Finish
Both
Mon
Please give further details here (please read guidance note 4)
Tue
Wed
State any seasonal variations for boxing or wrestling
entertainment (please read guidance note 5)
Thur
Fri
Non standard timings. Where you intend to use the
premises for boxing or wrestling entertainment at different
times to those listed in the column on the left, please list
(please read guidance note6)
Sat
Sun
E
Live music
Standard days and
timings (please read
guidance note 7)
Will the performance of live music take
place indoors or outdoors or both
please tick (please read guidance note 3)
Indoors
Outdoors
Day
Start
Finish
Both
Mon
Please give further details here (please read guidance note 4)
Tue
Wed
State any seasonal variations for the performance of live
music (please read guidance note 5)
Thur
Fri
Non standard timings. Where you intend to use the
premises for the performance of live music at different
times to those listed in the column on the left, please list
(please read guidance note 6)
Sat
Sun
F
Recorded music
Standard days and
timings (please read
guidance note 7)
Will the playing of recorded music take
place indoors or outdoors or both
please tick (please read guidance note 3)
Indoors
Outdoors
Day
Start
Finish
Both
Mon
Please give further details here (please read guidance note 4)
Tue
Wed
State any seasonal variations for the playing of recorded
music (please read guidance note 5)
Thur
Fri
Non standard timings. Where you intend to use the
premises for the playing of recorded music at different
times to those listed in the column on the left, please list
(please read guidance note 6)
Sat
Sun
G
Performances of
dance
Standard days and
timings (please read
guidance note 7)
Will the performance of dance take place
indoors or outdoors or both please tick
(please read guidance note 3)
Indoors
Outdoors
Day
Start
Finish
Both
Mon
Please give further details here (please read guidance note 4)
Tue
Wed
State any seasonal variations for the performance of dance
(please read guidance note 5)
Thur
Fri
Non standard timings. Where you intend to use the
premises for the performance of dance at different times to
those listed in the column on the left, please list (please
read guidance note 6)
Sat
Sun
H
Anything of a similar
description to that
falling within (e), (f)
or (g)
Standard days and
timings (please read
guidance note 7)
Please give a description of the type of entertainment you will
be providing
Day
Start
Finish
Will this entertainment take place indoors
or outdoors or both please tick (please
read guidance note 3)
Indoors
Mon
Outdoors
Both
Tue
Please give further details here (please read guidance note 4)
Wed
Thur
State any seasonal variations for entertainment of a similar
description to that falling within (e), (f) or (g) (please read
guidance note 5)
Fri
Sat
Non standard timings. Where you intend to use the
premises for the entertainment of a similar description to
that falling within (e), (f) or (g) at different times to those
listed in the column on the left, please list (please read
guidance note 6)
Sun
I
Late night
refreshment
Standard days and
timings (please read
guidance note 7)
Will the provision of late night
refreshment take place indoors or
outdoors or both please tick (please
read guidance note 3)
Indoors
Outdoors
Day
Start
Finish
Both
Mon
Please give further details here (please read guidance note 4)
Tue
Wed
State any seasonal variations for the provision of late night
refreshment (please read guidance note 5)
Thur
Fri
Non standard timings. Where you intend to use the
premises for the provision of late night refreshment at
different times, to those listed in the column on the left,
please list (please read guidance note 6)
Sat
Sun
J
Supply of alcohol
Standard days and
timings (please read
guidance note 7)
Will the supply of alcohol be for
consumption please tick (please read
guidance note 8)
On the
premises
Off the
premises
Day
Start
Finish
Both
Mon
State any seasonal variations for the supply of alcohol
(please read guidance note 5)
Tue
Wed
Thur
Non standard timings. Where you intend to use the
premises for the supply of alcohol at different times to
those listed in the column on the left, please list (please
read guidance note 6)
Fri
Sat
Sun
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K
Please highlight any adult entertainment or services, activities, or other
entertainment or matters ancillary to the use of the club premises that may give
rise to concern in respect of children (please read guidance note 9).
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L
Describe the steps you intend to take to promote the four licensing objectives:
a) General all four licensing objectives (b,c,d,e) (please read guidance note 10)
b) The prevention of crime and disorder
c) Public safety
d) The prevention of public nuisance
e) The protection of children from harm
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Checklist:
Please tick to indicate agreement
I have made or enclosed payment of the fee.
I have enclosed the plan of the premises.
I have sent copies of this application and plan to the responsible authorities.
I have completed and enclosed the club declaration and enclose a copy of the
club rules.
I understand that I must now advertise my application.
I understand that if I do not comply with the above requirements my application
will be rejected.
IT IS AN OFFENCE, UNDER SECTION 158 OF THE LICENSING ACT 2003, TO MAKE
A FALSE STATEMENT IN OR IN CONNECTION WITH THIS APPLICATION. THOSE
WHO MAKE A FALSE STATEMENT MAY BE LIABLE ON SUMMARY CONVICTION
TO A FINE OF ANY AMOUNT.
Part 3 Signatures (please read guidance note 11)
I
(Insert full name)
make this application on behalf of the club and have authority to bind the club
Signature
Date
Capacity
Address for correspondence associated with this application (please read guidance note
12)
Post town
Post code
Telephone number (if any)
If you would prefer us to correspond with you by e-mail your e-mail address (optional)
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Notes for Guidance
1. Describe the premises, for example the type of premises, its general situation and layout
and any other information which could be relevant to the licensing objectives. Where your
application includes off-supplies of alcohol and you intend to provide a place for
consumption of these off- supplies you must include a description of where the place will
be and its proximity to the premises.
2. In terms of specific regulated entertainments please note that:
Plays: no licence is required for performances between 08.00 and 23.00
on any day, provided that the audience does not exceed 500.
Films: no licence is required for ‘not-for-profit’ film exhibition held in
community premises between 08.00 and 23.00 on any day provided that
the audience does not exceed 500 and the organiser (a) gets consent to
the screening from a person who is responsible for the premises; and (b)
ensures that each such screening abides by age classification ratings.
Indoor sporting events: no licence is required for performances between
08.00 and 23.00 on any day, provided that the audience does not exceed
1000.
Boxing or Wrestling Entertainment: no licence is required for a contest,
exhibition or display of Greco-Roman wrestling, or freestyle wrestling
between 08.00 and 23.00 on any day, provided that the audience does
not exceed 1000. Combined fighting sports defined as a contest,
exhibition or display which combines boxing or wrestling with one or more
martial arts are licensable as a boxing or wrestling entertainment rather
than an indoor sporting event.
Live music: no licence permission is required for:
o a performance of unamplified live music between 08.00 and 23.00
on any day, on any premises.
o a performance of amplified live music between 08.00 and 23.00
on any day on premises authorised to sell alcohol for
consumption on those premises, provided that the audience does
not exceed 500.
o a performance of amplified live music between 08.00 and 23.00
on any day, in a workplace that is not licensed to sell alcohol on
those premises, provided that the audience does not exceed 500.
o a performance of amplified live music between 08.00 and 23.00
on any day, in a church hall, village hall, community hall, or other
similar community premises, that is not licensed by a premises
licence to sell alcohol, provided that (a) the audience does not
exceed 500, and (b) the organiser gets consent for the
performance from a person who is responsible for the premises.
o a performance of amplified live music between 08.00 and 23.00
on any day, at the non-residential premises of (i) a local authority,
or (ii) a school, or (iii) a hospital, provided that (a) the audience
does not exceed 500, and (b) the organiser gets consent for the
performance on the relevant premises from: (i) the local authority
concerned, or (ii) the school or (iii) the health care provider for the
hospital.
Recorded Music: no licence permission is required for:
o any playing of recorded music between 08.00 and 23.00 on any
day on premises authorised to sell alcohol for consumption on
those premises, provided that the audience does not exceed 500.
o any playing of recorded music between 08.00 and 23.00 on any
day, in a church hall, village hall, community hall, or other similar
community premises, that is not licensed by a premises licence to
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sell alcohol, provided that (a) the audience does not exceed 500,
and (b) the organiser gets consent for the performance from a
person who is responsible for the premises.
o any playing of recorded music between 08.00 and 23.00 on any
day, at the non-residential premises of (i) a local authority, or (ii) a
school, or (iii) a hospital, provided that (a) the audience does not
exceed 500, and (b) the organiser gets consent for the
performance on the relevant premises from: (i) the local authority
concerned, or (ii) the school proprietor or (iii) the health care
provider for the hospital.
Dance: no licence is required for performances between 08.00 and 23.00
on any day, provided that the audience does not exceed 500. However, a
performance which amounts to adult entertainment remains licensable.
Cross activity exemptions: no licence is required between 08.00 and
23.00 on any day, with no limit on audience size for:
o any entertainment taking place on the premises of the local
authority where the entertainment is provided by or on behalf of
the local authority;
o any entertainment taking place on the hospital premises of the
health care provider where the entertainment is provided by or on
behalf of the health care provider;
o any entertainment taking place on the premises of the school
where the entertainment is provided by or on behalf of the school
proprietor; and
any entertainment (excluding films and a boxing or wrestling
entertainment) taking place at a travelling circus, provided that (a)
it takes place within a moveable structure that accommodates the
audience, and (b) that the travelling circus has not been located
on the same site for more than 28 consecutive days.
3. Where taking place in a building or other structure please tick as appropriate (indoors
may include a tent).
4. Please state type of activity to be authorised, if not already stated, and give relevant
further details, for example (but not exclusively) whether or not music will be amplified or
unamplified.
5. For example (but not exclusively) where the activity will occur on additional days during
the summer months.
6. For example (but not exclusively), where you wish the activity to go on longer on a
particular day e.g. Christmas Eve.
7. Please give timings in 24 hour clock (e.g. 16.00) and only give details for the days of the
week when you intend the premises to be used for the activity.
8. If the club wishes members and their guests to be able to consume alcohol on the
premises please tick ‘on the premises’. If the club wishes people to be able to purchase
alcohol to consume away from the premises please tick ‘off the premises’. If the club
wishes people to be able to do both please tick ‘both’.
9. Please give information about anything intended to occur at the premises or ancillary to
the use of the premises which may give rise to concern in respect of children, regardless
of whether you intend children to have access to the premises, for example (but not
exclusively) nudity or semi-nudity, films for restricted age groups, gambling machines etc.
10. Please list here steps you will take to promote all four licensing objectives together.
11. The application form must be signed.
12. This is the address which we will use to correspond with the club about this application.