Community Facilities Hire Application Form

Please check availability of the venue you want to hire (date and time) before submitting this form

Term Hire: Regular Hire Casual Hire
(Short term hire is for 1 day or less)

(Date of hire or start date if long term)
Time From :
(Please include am or pm)
Time To :
(Please include am or pm)
Hirer:
(Name of the group/club/ organisation or private hire)
Contact person :
( Name of person responsible for hire )
Hirer type: Private Community Group
Contact Address :
* :
Contact Phone:
(Home, work or mobile phone)
Contact Email:
(Full internet email address)
Do you have public liability insurance? *: Yes (The certificate must be provided when booking is confirmed)
No   (Council's one off public liability fee per booking day will apply.)

Centre Information

Centre for hire:  

Type of function and proposed activities*:


(A short description of venue hire purpose)
Attendance numbers *:
Fee charged to participants *:
(Please enter not applicable if you will not be charging participants)
Will liquor be consumed *: Yes No
(LIQUOR LICENCE - A Limited Licence is required only if Liquor is to be SOLD or PROVIDED UNDER AN ALL INCLUSIVE CHARGE.)
If Yes

BYO HOST SUPPLY FOR SALE

 
Where do most of your group participants live?
  25% 50% 75% 100%
Local Neighbourhood
City of Port Phillip, but not in the Local Neighbourhood
Outside Port Phillip

The Conditions of Hire are to be read with this APPLICATION and form part of any AGREEMENT to HIRE the facilities mentioned in this APPLICATION.

A refundable security deposit hire & public liability insurance fees must be lodged at least seven working days prior to hire venue.

In making this application, it is acknowledged that the document, Application of hire has been received & examined by Community Facilities Officer & I am/we are fully aware of & accept that, should this application be approved, the conditions, indemnities & other requirements set out in that document become part of the AGREEMENT TO HIRE the facilities mentioned in the application. I also understand a breach of these conditions could lead to cancellation of future booking or loss of security deposit where applicable.

Clicking submit is NOT a confirmation of the venue hire. A Community Facility Officer will confirm this booking application.

 

If you have any difficulties with this form, you can contact the City of Port Phillip via email ppol@portphillip.vic.gov.au
See the City of Port Phillip Privacy statement.
http://www.portphillip.vic.gov.au/