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Room Hire at Mount Martha House
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Room Hire at Mount Martha House
Room Hire at Mount Martha House
Karen Aurelio
2021-08-03T05:09:04+00:00
Room Hire Form
"
*
" indicates required fields
Club/Organisation Details
Primary Contact Name
*
First
Last
Club/Organisation Name
Position in Club/Organisation
Business / Organisation Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Phone number
*
Email
*
ABN Number
Secondary Contact Name
First
Last
Secondary Contact Phone number
Booking 1
Name of Activity/Class/Program and brief description
*
Start Date
*
DD slash MM slash YYYY
End Date
*
DD slash MM slash YYYY
Start Time
Hours
:
Minutes
AM
PM
AM/PM
End Time
Hours
:
Minutes
AM
PM
AM/PM
Program Duration in hours
Minimum participants
Maximum participants
Program frequency (if applicable)
Once off
Weekly
Fortnightly
Monthly
Booking 2
Name of Activity/Class/Program and brief description
Is your event open to the public?
*
Yes
No
Do you require this booking during the school holidays?
*
Yes
No
Will you be selling food?
*
This includes if it is built-in to an entry fee/ticket price
Yes
No
Will there be alcohol at your event/program/activity?
*
Yes
No
Other comments
Public Liability Insurance
Public Liability Insurance is required for all facilitators/hirers. Please attach a copy of your current Certificate of Currency. Public Liability Insurance must be valid to $10,000,000.
File
Max. file size: 256 MB.
Insurance Expiry Date
DD slash MM slash YYYY
Consent
I have read and agree to the
Conditions of Hire
I hereby make an application and acknowledge having read the Conditions of Hire and undertake to be bound by and comply with these Conditions in every aspect. I further undertake to be responsible for ensuring that ll individuals or groups using the premises in association with this application shall comply with the Conditions.
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