City of Kingston – Pavilion and Key Changeover Form

PAVILION & KEY CHANGEOVER FORM

Pavilion Inspection

Reserve:______

Pavilion:______

Alarm:YESNOCode/Key:______

Tenant Clubs:

______

Sporting Club ASporting Club B

______

Sporting Club CSporting Club D

Pavilion / Room Condition / Equipment Condition / Comments
Social Room
Bar
Kitchen
Kiosk
Storage Rooms
Meeting Rooms
First Aid Room
Toilets - Social Room
Change Rooms
Umpires Room
Toilets - Change Room
Showers
Fire Equipment Facilities
Security Lights (external)
Exit Lights (internal)

VG= Very GoodB=Bad

G=GoodVB=Very Bad

A=AverageNE=Non Existent

Please note: Maintenance items that are the responsibility of Council must be logged with the Customer Service Action Line by calling 1300 653 356 or emailing details to

Sporting Ground / Condition / Comments
Sporting Surface
Training Lights
Gates
Cricket Nets
Goal Posts
General Remarks:

 The pavilion/ground was in a clean and tidy condition.

 The pavilion/ground was not in a clean and tidy condition.

The ______

Name of responsible Club(s)

will organise for the following to be done:

Description / Completion Date

If the work is not completed by the outlined date, Council will carry out the work and will charge the responsible Club(s) accordingly.

Utility Changeover

Please ensure that all utilities have been changed over in accordance with the requirements of the utility company. Council bears no responsibility for the utilities.

Utility Company / Departing Tenant Club Advised Utility Company / Incoming Tenant Club Advised Utility Company
Y/N ___/____/____ / Y/N ___/____/____
Y/N ___/____/____ / Y/N ___/____/____
Y/N ___/____/____ / Y/N ___/____/____

Key Exchange

Returning Club Name ______

Returning Club Representative ______

(Please print name)

Returning Club Name ______

Returning Club Representative ______

(Please print name)

Receiving Club Name ______

Receiving Club Representative ______

(Please print name)

Receiving Club Name ______

Receiving Club Representative ______

(Please print name)

Date / Key number by quantity
eg A32 x 2 / Returning Club Signature/s / Receiving Club Signature/s

______

Date of Inspection

______

Printed name of representative Club ASignature of Sporting Club A

______

Printed name of representative Club BSignature of Sporting Club B

______

Printed name of representative Club CSignature of Sporting Club C

______

Printed name of representative Club DSignature of Sporting Club D

NB The incoming tenant club is responsible for returning the changeover form to City of Kingston prior to seasonal allocation being confirmed.

Leisure & CulturePage 1 of 4Seasonal Sporting Ground Allocations