Casual Venue Hire - Application Form Hirer's DetailsOrganisation Name(if applicable)*Contact Person*Postal Address*Suburb*State*ACTNSWQLDVICSANTTASWAPostcode*Telephone*Mobile*Email* *The person completing and signing the declaration on this application form must provide a copy of their drivers licence or suitable photographic ID when submitting their Venue Hire Application Form (email copy to venue.hire@northside.asn.au) Venue SelectionPlease note: * All prices include GST * Capacity is maximum number permitted in venue Not For Profit Rate Per Hour Standard Rate Per Hour Please Select Venue Corroboree Park Paterson Street, Ainslie Corroboree Park Function Room (Capacity 60) $38.00 $31.00 Corroboree Park Function Room (Capacity 60) Corroboree Park Hall (Capacity 100) $38.00 $31.00 Corroboree Park Hall (Capacity 100) Majura Community Centre 2 Rosevear Place, Dickson Majura Function Room (Capacity 35) $38.00 $31.00 Majura Function Room (Capacity 35) Majura Hall (Capacity 150) $58.00 $47.00 Majura Hall (Capacity 150) Palmerston Community Centre Tiptree Crescent, Palmerston Palmerston Function Room (Capacity 80) $38.00 $31.00 Palmerston Function Room (Capacity 80) Palmerston Meeting Room (Capacity 20) $32.00 $26.00 Palmerston Meeting Room (Capacity 20) Venue Hire SurchargesSURCHARGES All casual (one off) bookings will incur the following surcharge in addition to the hourly rates: * Please refer to the Venue Hire Terms and Conditions for full details Casual Booking Surcharge Friday, Saturday, Sunday and all Public Holidays $140 Casual Booking Surcharge Monday to Thursday (excluding Public Holidays) $60Are you registered as a Not-For-Profit organisation?*Are you registered as a Not-For-Profit organisation?If yes, you must provide a copy of your Certificate of Incorporation (email to venue.hire@northside.asn.au)YesNoDo you have current Public Liability Insurance?*Do you have current Public Liability Insurance?If yes, you must provide a copy of your Certificate of CurrencyYesNoVenue Hire DetailsPlease note: *Set up and pack away time needs to be included in your entry and exit times. *Parties/functions for anyone between the ages of 12 and 30 are strictly not permitted. Charges will apply for false or misleading information provided on the application form *Please refer to the Venue Hire Terms and Conditions for full detailsDay of hire*Select day of HireMondayTuesdayWednesdayThursdayFridaySaturdaySundayDate of hire* Entry time8:00am8:30am9:00am9:30am10:00am10:30am11:00am11:30am12:00pm12:30pm1:00pm1:30pm2:00pm2:30pm3:00pm3:30pm4:00pm4:30pm5:00pm5:30pm6:00pm6:30pm7:00pm7:30pm8:00pm8:30pm9:00pm9:30pm10:00pm10:30pm11:00pm11:30pm12:00am (midnight)Exit time8:00am8:30am9:00am9:30am10:00am10:30am11:00am11:30am12:00pm12:30pm1:00pm1:30pm2:00pm2:30pm3:00pm3:30pm4:00pm4:30pm5:00pm5:30pm6:00pm6:30pm7:00pm7:30pm8:00pm8:30pm9:00pm9:30pm10:00pm10:30pm11:00pm11:30pm12:00am (midnight)Purpose of hire*Number of guests attending*Additional notesWill alcohol be sold at this event?*Will alcohol be sold at this event?*please refer to terms and conditionsYesNoWill alcohol be permitted at this event?*Will alcohol be permitted at this event?YesNoWill this event be publicly advertised?*Will this event be publicly advertised?YesNoIf yes, where?Declaration* I have read and understand the Venue Hire Terms and Conditions as well as any additional conditions of use as issued by Northside Community Service and agree to abide by these conditions. I understand the period of hire shall commence and conclude strictly at the agreed times confirmed by Northside Community Service and the venue must be vacated promptly at the conclusion of the hiring period. An extra charge will be imposed for any additional time used which is not booked in advance. I undertake to be responsible for leaving the premises in its original condition and will be liable for any damage caused whilst on premises. I understand that I will be required to complete a Credit Card Security Bond Form for a bond amount of $500. I understand that when I collect the key to the hire venue, the credit card details will be used for a pre-authorisation transaction to check there are funds to the value of $500 on the credit card and the pre-authorisation will put a hold on these funds. The bond amount will be held until the conclusion of the hiring period (approximately 5 to 7 working days from the pre-authorisation date). The credit card will be charged if there is a need for a bond deduction as per the items listed in the Schedule of Additional Charges outlined in the Venue Hire Terms and Conditions. AgreeDisagree