Online Booking Form

Your Details

Full details of person (18 years of age or over) or organisation making application:

Name * required

Address * required

Daytime Contact Number * required

Mobile

I have read and agree to the condition of hire *

Yes

Function Details

Name of Venue

Type of Function (ie birthday party, please provide age) * required

Select Function Date * requiredSelect Function Date * required

May 2013 M T W T F S S 18 29 30 1 2 3 4 5 19 6 7 8 9 10 11 12 20 13 14 15 16 17 18 19 21 20 21 22 23 24 25 26 22 27 28 29 30 31 1 2 23 3 4 5 6 7 8 9

Time of Function

Start Time * required

Finish Time

Please note all music should be turned off by 12.00am and the premises vacated by 1.00am

Setting Up Time

Number of Guests * required

Facilities Required *

Kitchen Stage Main Hall Toilets Meeting Room

Other

Will tickets be sold for this function? *

Yes No

Will liquor be consumed at this function? *

Yes No

If yes, is the hirer providing the liquor?

Yes No

Or, are patrons to being their own?

Yes No

Is liquor to be offered for sale?

Yes No

If yes, please provide your Liquor License Number

Caterer's details, if applicable

You are reminded that underage drinking is an offence.

Will the function be for persons under the age of 21?

Yes No

If yes, you confirm that there will be one adult per 25 children in attendance

Yes

Fees & Charges Payable

Hire Cost

Bond

Insurance

Declaration

Signed (please enter your name)

I have read and agree to abide by all the conditions of hire . I declare the above information is correct, and I understand that providing false or misleading information will result in forfeiture of the bond, and may result in civil action.

DateDate

May 2013 M T W T F S S 18 29 30 1 2 3 4 5 19 6 7 8 9 10 11 12 20 13 14 15 16 17 18 19 21 20 21 22 23 24 25 26 22 27 28 29 30 31 1 2 23 3 4 5 6 7 8 9

Position in Organisation (if applicable)