C3 HED Hire Application

C3 HED Hire Application

Please note that completing this form does not confirm your hire, from this form we will compile your quote which you will receive via email. Only after the quote and terms & conditions are accepted in writing is your hire confirmed.
Your Information
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Who is this hire for?

Business/CompanyCommunity GroupNot-For-ProfitIndividualC3 Port Hedland Member/PartnerOther
Business Details
Business Name
Business Location
Are you classified as a Not-For-Profit

YesNo
Hire Details
What is the frequency of the event?

One-off hireRepeat hire - weeklyRepeat hire - not weekly
Hire Start

DayMonthYear
Date & Time access will first be required to the building - including set up & dropping off anything.
Hour MinutesAM/PM Option
Hire End

DayMonthYear
Date & Time after which access to the venue will no longer be required - including pack up & cleaning etc.
Hour MinutesAM/PM Option
Event Start

DayMonthYear
Date & Time Event will start
Hour MinutesAM/PM Option
Event End

DayMonthYear
Date & Time Event will finish
Hour MinutesAM/PM Option
Please select the room(s) you would like to hire

Auditorium (Cap 114)Multi Purpose Room (Cap 60)Break Out RoomEntry FoyerDining RoomKitchen
What is the nature of your event
eg. Birthday Party, Cooking class, Business Meeting, Corporate Event etc.
Is your event open to the general public?

YesNo
Is your event free to attend?

YesNo
How many people do you expect to attend your event?
Will you require any Audio Visual Equipment? E.g. Microphone,

YesNo
Is there anything else you'd like us to know about your event?
Alcohol

There will be no alcohol at my eventAlcohol will be available at my eventAlcohol will be on sale at my eventAlcohol is part of a fundraising prize/game at my eventOther
Alcohol licencing laws apply. This is not a licenced venue. The hirer is responsible for obtaining all the correct licencing and documentation, and informing police as necessary prior to their event.
In-House Equipment requested (please select all that apply)

Standard Tables (1.8m x 0.6m)Standard Table ClothsStandard ChairsCafe TablesCafe ChairsBar TablesBar Table CoversBar StoolsCouchesCutlery, Crockery, & ServingwareDishwasherTV/ScreenAudio playback*Microphone*Powerpoint Presentation or video playback*Stage Lighting*Live streaming FROM us (Streaming your event online)*Live streaming TO us (Streamed in from elsewhere)*
Please provide numbers required for tables/chairs/cutlery etc.
*These items may incur additional staff and equipment hire costs
Should your hire application be successful, you will be required to provide evidence of a current Public Liability Insurance policy. This applies to all hires, regardless of the nature or hirer. If you already hold a Public Liability Policy, please Submit your certificate of currency here to speed up the application process. If you do not have this, we recommend purchasing a one-off license here: https://www.localcommunityinsurance.com.au/quote/?appref=73684288598

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C3 HED Hire Application

Your Information

Business Details

Hire Details