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Application for Facility Hire – Sporting Facilities

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Applicant Details

Contact Name

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Organisation / Group

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Address Details

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Email address

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Phone Numbers

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Sports Council delegates

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Facility Booking Details

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Facilities required: *

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Facilities required: *

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Facilities required: *

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Room Requirements: *

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Function Room Items Requirements: *

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Meeting Room Items Requirements: *

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Facilities required: *

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Function Room Space Requirements: *

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Function Room Item Requirements: *

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Facilities required: *

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Facilities required: *

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Function Room Space Requirements: *

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Function Room Item Requirements: *

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Facilities required: *

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Facilities required: *

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Mallabulla Sport Complex Field Map
Facilities required: *

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Function Room Space Requirements: *

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Function Room Items Requirements: *

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Facilities required: *

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Function Room Space Requirements: *

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Function Room Items Requirements: *

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Facilities required: *

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Facilities required: *

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Facilities required: *

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Enter other facilities required

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Frequency of Hire

Booking Type: *

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Day/s requested: *

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Please Note: blanket bookings are not permitted and specific times need to be entered for each day.

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Hire Details

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Number of registered players (if applicable)

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Number of teams (if applicable)

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Public Liability

Do you have Public Liability for $20 million: *

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Please attach a copy of your Certificate of Currency with Port Stephens Council noted as an interest
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Food and Beverage

Are you preparing food at the facility for retail sale?: *

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Will alcohol be present at the facility during the hire period?: *

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How will alcohol be distributed?: *

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Have you obtained a Liquor Licence?: *

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As per Terms and Conditions of Facility Hire:

  • A copy of the Hirer’s liquor licence must be provided to Council prior to hire.
  • A Responsible Service of Alcohol (RSA) Certificate is required for any staff member serving alcohol and will need to be provided to Council by the Hirer.
(maximum 10 MB per file; limit 3 files)
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Contractor Information

Are you engaging any contractors for your activity?: *
Contractor Types: Food Vendors (including Coffee Vans) and Jumping Castles Only

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Contractor 1's Details

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Is the vendor registered with Port Stephens Council?: *

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(maximum 10 MB per file; limit 3 files)
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â›” The Food Vendor must register with Port Stephens Council before operating in the area. 

đź“ť The Food Vendor must complete a Mobile Food Vending Vehicle Application that can be uploaded as part of this application. 

(maximum 10 MB per file; limit 3 files)
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Contractor 2's Details

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Is the vendor registered with Port Stephens Council?: *

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(maximum 10 MB per file; limit 3 files)
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â›” The Food Vendor must register with Port Stephens Council before operating in the area. 

đź“ť The Food Vendor must complete a Mobile Food Vending Vehicle Application that can be uploaded as part of this application. 

(maximum 10 MB per file; limit 3 files)
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Contractor 3's Details

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Is the vendor registered with Port Stephens Council?: *

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(maximum 10 MB per file; limit 3 files)
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â›” The Food Vendor must register with Port Stephens Council before operating in the area. 

đź“ť The Food Vendor must complete a Mobile Food Vending Vehicle Application that can be uploaded as part of this application. 

(maximum 10 MB per file; limit 3 files)
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📧 If the number of Contractors is over 3, please email the detail to facilitybookings@portstephens.nsw.gov.au. 

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Terms and Conditions

Please review Terms and Conditions of Facility Hire prior to accepting the below declaration
Please visit Council's current Fees and Charges for applicable hire fees. 

Please note: Council's fees and charges are updated each year on 1 July. 

Declaration

I, the applicant hiring this facility, am 18 years of age or over and have read/understood the Terms and Conditions of Facility Hire. I agree to comply with local laws and all relevant legislation.  I indemnify Port Stephens Council from and against all claims arising from the hirer’s legal liability as a result of its occupancy. I understand that this application for Facility Hire does not constitute an acceptance of the booking.

Tick to acknowledge your acceptance of the above declaration

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Date:
Date:
today
Name:
User type:
Signature: *

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YOUR PRIVACY

Port Stephens Council is committed to protecting your privacy. We take reasonable steps to comply with relevant legislation and Council policy.

Purpose: The purpose of this form is to enable Council to record the matter raised and taken appropriate action.

Intended recipients: Council employees, contractors and other third parties where appropriate.

Supply: Voluntary.

Consequence of Non Provision: Council may not take action on the matter raised.

Storage and security: This document will be placed on the relevant file and/or saved in Council’s records management system in accordance with Council policy and relevant legislation.

Access: Please contact Council on 02 4988 0255 to enquire how you can access information.

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