NORTHCOTE TOWN HALL

189 High Street, Northcote 3070

t: 03 9481 9500 f: 03 9261 4868

ABN: 75 815 980 522

www.northcotetownhall.com.au

BOOKING APPLICATION FORM

HIRE INFORMATION

PLEASE TICK: MEETING FUNCTION EVENT REHEARSAL PERFORMANCE
NAME OF ORGANISATION/GROUP:
DESCRIPTION OF ACTIVITY:
INFORMATION ON SIGNAGE: / NUMBER OF PARTICIPANTS:
HAVE YOU BOOKED AT THE NORTHCOTE TOWN HALL BEFORE? NO YES
FOR DAREBIN CITY COUNCIL BOOKINGS ONLY GL: ______/ ______/ 4 2 3 6 / __
IS THE GROUP A NOT-FOR-PROFIT ORGANISATION? NO YES Incorporation Number:
DO YOU HAVE PUBLIC LIABILITY INSURANCE? NO YES Please attach a copy of your insurance details
IS THIS BOOKING TICKETED?
YES NO Not Applicable If yes, please complete the Northcote Town Hall ticketing application form.

PRINCIPAL CONTACT

NAME: / ROLE:
ADDRESS: / POSTCODE:
PHONE (B/H): / (A/H):
MOBILE: / EMAIL:

CONTACT FOR INVOICING (if different from above)

NAME: / ROLE:
ADDRESS: / POSTCODE:
PHONE (B/H): / (A/H):
MOBILE: / EMAIL:

ROOM HIRE DETAILS

Please attach a separate sheet or calendar if there is insufficient space below
ROOM/S NAME / DATE/S REQUESTED / ACCESS TIMES
(these are the hours for which the hirer will be charged) / EVENT TIME / TOTAL HOURS

ROOM SET UP

Clear Floor Space / Theatre/Forum / Board room
U-Shape (with tables and chairs) / U-Shape (chairs only) / Banquet Style (round tables and chairs)
Table at the front of room / Extra chairs (amount )
Please attach a plan for alternative set up

STORAGE

Will you require storage space? NO YES

No storage is available without prior arrangement. Fees may apply. Please contact booking staff for more information.

NOISE LEVELS

Nil / Low / Mid / High (max +55db)
Hirers must provide full details of proposed activities and are advised to discuss with the Venue Staff any issues regarding the type of noise, noise levels, style of entertainment, including singing, drumming, amplified speech, active group movement.

EQUIPMENT HIRE

NB: some items will incur a hire fee

Whiteboard / $
Projector Screen / $
Data Projector / $
Powerboard and Extension Lead / $
Other (please specify) / $

TEA, COFFEE & CATERING FACILITIES

NB: items may incur a hire fee

Not Required
Hot Water Urn / $
Cups, Saucers, Teaspoons / $
Tea/Instant Coffee/Sugar/Milk $3.00 per person / $
Water Glasses / $
Water Jugs (With Cold Water) / $
Glassware (white, red, sparkling wine glasses, beer glasses etc) – please specify ______ / $
Plates and bowls (cake and dinner plates, soup and dessert bowls) – please specify ______ / $

KITCHEN & CATERING INFORMATION

WILL YOU NEED ACCESS TO A KITCHEN?
(charges may apply for use of the kitchen/s) / YES NO
WILL YOU BE SELLING FOOD & SOFT DRINKS? / YES NO
If YES, please phone the Council Health Department (03) 8470 8658 to obtain information regarding temporary food event permits. Documents will need to be attached to this application form.
WILL YOU BE PROVIDING ALCOHOL? / YES NO
Northcote Town Hall holds an on-premises liquor license and only the venue may sell alcohol in accordance to their trading hours. Please review our House Policy in regards to the service of alcohol in the venue.
DO YOU REQUIRE STORAGE OPTIONS FOR CATERING/STOCK PRIOR OR POST YOUR EVENT? / YES NO
If YES, please note that charges may apply.
WILL YOU BE SELF CATERING? / YES NO
WILL YOU BE HIRING A CATERER? / YES NO If YES, please provide information below
Caterer’s Name & Contact Number:
Food Registration Number :

STAFFING, SECURITY & CROWD CONTROLLERS

All functions and events require a Duty Supervisor to oversee the entirety of the hire. Some events will require security at the request of the Venue Manager. Functions and events require two security guards for every 100 patrons (or part thereof) or if deemed required by the venue. Northcote Town Hall will organise staffing and security and charges will be added to the hirer’s invoice. Security and crowd controllers will need to report to Northcote Town Hall staff on arrival and complete the Security Register.
Northcote Town Hall holds the right to open a bar during your event, festival or performance. An event that will be providing alcohol for consumption and that will not be selling liquor may be required to hire Northcote Town Hall bar staff who are trained and have their Responsible Service of Alcohol certificate.
Hirers may be directed to provide security/crowd controllers, a bar manager and/or technicians during the period of hire. The hirer shall be responsible for any costs involved in such attendance. Please see brochures for requirements and costs.
Duty Supervisor / $
Security Crowd Controllers / $
Bar Manager / $
Bar Staff / $
Front of House Supervisor / $
Front of House Ushers / $
Technicians / $

PROMOTIONAL INFORMATION

E-NEWSLETTER - Northcote Town Hall publishes a monthly enewsletter where events, performances and monthly activities are advertised. Please visit www.northcotetownhall.com.au to subscribe.

WEBSITE - Northcote Town Hall provides a Calendar of Events on our website for hirers to add their own details of their up-coming meetings, events, training sessions and performances. Please visit www.northcotetownhall.com.au, click EVENT, then ADD EVENT. Complete the required fields on the form and press SUBMIT EVENT. Your entry will be published once approved.

PAYMENT

All events and performances are to be paid in full before the date of the event. You will be required to pay you bond within 10 days of receiving your tax invoice and confirmation. If there are any concerns about paying, please contact the booking staff. Payment instalments may be negotiated. Ticketed performance and events can may alternative arrangements for room hire payments to be deducted from ticket sales. Please contact booking staff to confirm this arrangement.

For meetings and passive recreation bookings, an invoice will be sent to the hirer prior to the date of room hire. If bookings are weekly or monthly, invoices will be sent to the hirer on a monthly basis. If a booking is made less than 48 hours prior to the event, payment of the event must be made upon booking.

You may pay prior to your booking at the Northcote Town Hall by cash, card or cheque between office hours.

CANCELLATIONS

All cancellation are to be made in writing and sent to . Cancellations over the phone will not be accepted.

For Meetings and Passive Recreation Bookings:

Full payment will be charged if cancellation is received less than seven (7) days prior to the hire date.

25% payment will be charged if cancellation is received 7-30 days prior to the hire date.

For Functions, Performances and Events:

Full payment will be charged if cancellation is received less than thirty (30) days prior to the hire date.

25% payment will be charged if cancellation is received 30-60 days prior to the hire date.

This is an application to apply for room hire.

Completion of this application does not necessarily mean approval will be given.

The Hirer agrees to indemnify and to keep indemnified, the Council, its servants and agents, and each of them from and against all actions, costs, claims, charges, expenses, penalties, demands and damages whatsoever which may be brought or made or claimed against them, or any of them in connection with the Hirers performance or purported performance of its obligations under this Agreement and be directly related to the negligent acts, errors or omission of the Hirer. The Hirers liability to indemnify the Council shall be reduced proportionally to the extent that any act or omission of the Council, its servants or agents, contributed to the loss or liability.

Personal information requested such as name and address, is collected for the purpose of registering and administering applications for hiring of council facilities. The personal information collected will not be used for any other purpose or disclosed except as may be required by law. If you do not provide the information then your application may not be processed. You may access the information collected about you by contacting us on (03) 9481 9500.

When booking a space at the Northcote Town Hall, a quote will be sent to the hirer. This quote is valid for seven days, and if not confirmed within that time your booking will be cancelled.
Please check that all equipment and times on the quote are correct and still meet your requirements. Changes can be made by return email within seven days. Changes made subsequent to confirmation of your booking may incur administration charges.
To proceed with this booking, please indicate via return email that you accept the charges and details. Following acceptance of your booking you will be sent an updated Confirmation / Tax Invoice document and your booking will become valid and be subject to our cancellation policy.

I agree with all of the conditions and upon acceptance of this application I agree to comply, with all respects outlined in the Northcote Town Hall Conditions of Hire.

SIGNATURE OF APPLICANT ______DATE ___ / ___ / ___

All bookings will be confirmed in writing. Booking Forms can be faxed to (03) 9261 4868 or sent by email to .

All forms MUST be signed to acknowledge full understanding of the conditions of hire.

OFFICE USE ONLY

Booking Received DATE:

Booking Entered in EP DATE: EP Number:

Quote Sent DATE: Debtor:

Quote Accepted DATE:

Booking Confirmation and Invoice sent DATE:

Invoice sent to Darebin Finance Dept. DATE:

Northcote Town Hall 2013-2014 Booking Application Form

Last Updated: 05/07/2013

Objective: A1625797 Page 1 of 4