Welcome!

This form is designed to gain important information about your event at St Albans Community Centre so we can best help make it a great experience for you and your guests. If you have any questions please call 9249 4600.

Primary contact details

Contact name:

First Name *

Last Name

Address:

Address 1 *

City

ZIP / Postal Code

State / Province

Email: *

Phone number: *

Second nominated responsible person that will be present at the event

Contact name:

First Name *

Last Name

Relationship to you: *

Address:

Address 1 *

City

ZIP / Postal Code

State / Province

Email: *

Phone number: *

Organisation details (if applicable)

Booking on behalf of:

Company (including Sole Traders)

Community

Individual

Group/organisation name:

Please note the documents required to your booking:

Company
- • ABN / Business Registration
  • Public Liability Insurance Certificate (cover must be a minimul of $20 million)
  - Community
    • Certificate of incorporation
    • Evidence that the group is voluntary
    • Evidence that the group receives minimal to no funding and group/program with at least 50% of its members being Brimbank residents.
    • Public Liability Insurance Certificate (cover must be a minimal of $20 million)
    - Individual
      • Photo ID - front and back (eg. Driver's License)

ABN:

Please enter your 11 digit ABN without spaces

Please upload a copy of your Certificate of Incorporation and/or Business Registration, if applicable

Event details

*If you selected birthday, please indicate the age:

*Fundraisers

Provide the name of every person or organisation that will benefit from the fundraising appeal

Provide a letter of consent from each beneficiary/organisation

When you are raising money it is important that you comply with all the relevant legislation and regulations surrounding fundraising, food handling, gambling and the sale of alcohol. Fundraising that takes place within an organisation and is targeted at past and present members and their relatives (rather than the general public), even if the fundraising is for an outside cause is NOT subject to the Fundraising Appeals Act 1988. However, even if you are an exempt fundraiser, you must still comply with general conduct requirements.

Upload fundraising documents if relevant

Room/s requested:

Flexible Space 1

Flexible Space 2

Flexible Space 3

I require additional spaces for prayer/VIP’s/organisers/performers/breakout groups etc (additional spaces will incur additional fees and are subject to availability)

Select which room/s you would like to book

Number of attendees/guests: *

Date of booking: *

Day *

Month *

Year *

Start time: *

Please allow for set-up as access will only be provided for the time stated

Finish time: *

Please allow for pack-up as access will only be provided for the time stated

Is your date flexible? *

Yes, please contact me to discuss alternative dates

No, I am unable to change my date

If your requested date is unavailable, please let us know if you would like to discuss alternative dates.

Do you require a kitchen? *

Yes

Will food be sold on the night including for fundraisers, dinner dances and other ticketed events? *

Yes

If yes, contact Environmental Health on 9249 4925 for advice and to obtain a food license if required

Will alcohol be available on the night including for fundraisers, dinner dances and other ticketed events? *

Yes, alcohol will be for sale

Yes, supplied free of charge

Any hirer which supplies alcohol on any Council premises must ensure that it satisfies all material laws and regulations and in particular all requirements of the Victorian Gambling and Casino Control Commission, including applying for and obtaining any licence that may be required by VGCCC and providing a copy of any such licence to STACC. VGCCC can be contacted on 1300 182 457.

Are there any other details we should know?

Required documentation

Photo ID (front & back) *

Privacy statement *

I understand that the personal information requested on this form is being collected by Council for reference and identification purposes. To ensure confidentiality of information requested Council will only use personal information provided for the purpose of providing a range of access to facilities and equipment. In accord with our Privacy Policy, we will not disclose your personal information without consent to a third party, institution or authority except where required by law or other regulation.

Indemnity *

I, the hirer, agree to indemnify and keep indemnified the Council, its servants and agents and each of them from and against all actions, costs, claims, charges, expenses and damages whatsoever which may be brought or made or claimed against them arising out of or in relation to this Agreement, to the extent permitted by law.

Conditions of Use *

By ticking this box I am accepting that I have read and understood the Conditions of Use and agree with all of the terms outlined

Please upload a signed copy of the Conditions of Use *

Function & Event Hire Application Form

Primary contact details

Second nominated responsible person that will be present at the event

Organisation details (if applicable)

Event details

Required documentation

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