City of Port Phillip

Regular Hire Applications for 1 July 2021 - 30 June 2022 are open from Monday 3rd May - Sunday 16th May 2021.

Assessment of all hire applications will be conducted in accordance with the Community Access and Allocation Policy and further information about the process can be found in the Regular Hire Application Package Document.

Please note that we cannot guarantee that your requested day, time and venue will be available.

Hirer Type*

Private Community Group Semi-commercial

This field is mandatory

Name of Facility you would like to hire*

One booking application for each Community Facility.

This field is mandatory

Booking Name*

This field is mandatory

Booking Schedule*

Recurring Booking Booking by Date

This field is mandatory

Please fill out the required fields and click Add

Time From*	Time To*	Room/Space Required* e.g. meeting room/hall/studio	Month*	Week*	Mon	Tue	Wed	Thu	Fri	Sat	Sun	Click Add*

Booking times must including set-up, pack down and cleaning time. Hirers cannot access the venue to do this outside the selected booking times

You have missed out some entries.

The above fields are mandatory. You must click the Add button

Please fill out the required fields and click Add

Time From*	Time To*	Room/Space Required* e.g. meeting room/hall/studio	Date of Hire*	Click Add*

Booking times must including set-up, pack down and cleaning time. Hirers cannot access the venue to do this outside the selected booking times

You have missed out some entries.

The above fields are mandatory. You must click the Add button

Will the venue be required on Public holidays*

Yes No

This field is mandatory

Will the venue be required during Victoria school term breaks*

Yes No

This field is mandatory

Will you require breaks at other times*

Yes No

This field is mandatory

List dates*

If breaking at other times, please provide dates and holiday name.

1000 character(s) remaining.

This field is mandatory

Additional information

Are there any other details you would like to provide or share a story from your group/program.

1000 character(s) remaining.

This field is mandatory

Activity Type

Group or Club Name*

This field is mandatory

Incorporated Association?*

Yes No N/A

This field is mandatory

Type of activities/program you provide*

1000 character(s) remaining.

This field is mandatory

Is this activity/program funded by any Council Grants?*

Yes No

This field is mandatory

How does your program benefit the Port Phillip Community and local residents?*

1000 character(s) remaining.

This field is mandatory

Is your group flexible with venue and/or dates & times?*

Yes No

This field is mandatory

Is your group underrepresented in the community?*

Yes No

This field is mandatory

Has your program run in a City of Port Phillip venue previously?*

Yes No

This field is mandatory

Number of attendees*

Approximate number of people who will be involved at each session.

This field is mandatory

Is your not-for-profit group run by it's own committee?*

Yes No
N/A

This field is mandatory

Can you demonstrate that over 65% of members are aged over 65 and reside within the City of Port Phillip?*

Yes No

This field is mandatory

Is a fee charged to participants?*

Yes No

This field is mandatory

Will you track attendance via electronic QR code?*

Yes No

This field is mandatory

Where do most of your group participants live?

	25%	50%	75%	100%
Within City of Port Phillip
Outside Port Phillip

This section is mandatory

What date would you like to start (from 1 July)?*

This field is mandatory

Booking contact details

Contact Name*

This person is responsible for updating the Venue Management with booking and contact changes

This field is mandatory

Position held in Group/Club

Address*

300 character(s) remaining.

This field is mandatory.

Phone*

Home, work or mobile phone.

This field is mandatory

Email*

Please provide your email if you would like to receive a copy of the application.

This field should be a valid email address

Security Deposits and Refunds

Preferred method for security bond return*

EFT Cheque

This field is mandatory

Account name*

This field is mandatory

BSB*

This field is mandatory

Account number*

This field is mandatory

Note: Account Name must match the applicant/Group

Compliance

Do you have Public Liability Insurance?*

Yes
No Council's one off public liability fee per booking day may apply

This field is mandatory

Have you undertaken a risk assessment of your event clearly identifying potential risks and possible mitigations?*

Yes No

This field is mandatory

Have you completed the COVID Safe Checklist for Venue Hire?*

Yes No

This field is mandatory

Document attachments section

To upload a document, click "Choose file" follow by clicking "Upload" button. Once your document is uploaded, it will appear in 'Uploaded attachment' section

Attach Public Liability Insurance

Attach Covid Safe Checklist*

Uploaded attachments

Can all the information on this form be used*

Yes No

This information can be used in the centre/activity promotion or in information provided to potential members, or published in information booklets,etc.

Please indicate*

If you do not want this information or any part of the information used, please indicate.

1000 character(s) remaining.

I have read and agreed to the Community Facilities Hire Terms and Conditions.

This field is mandatory.Please confirm that you have read the Community Facility Hire Terms and Conditions.

Community Facility Hirer Application Form 1 July 2021 - 30 June 2022

Recurring Booking

Booking by Date

Activity Type

Booking contact details

Security Deposits and Refunds

Compliance

Document attachments section

Uploaded attachments