130 Dryburgh Street
North Melbourne VIC 3051
admin@lucyguerininc.com
+61(0)3 9329 4213
Hirer questionnaire:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
*
example@example.com
ABN
Please select the option which applies to you:
*
Please Select
Independent Artist
Not-for-profit organisation
Commercial entity
Other
What kind of activity are you hiring for?
*
Is this activity/project funded or unfunded?
*
Please Select
Funded
Unfunded
Other
Date required
*
Time required:
*
Have you hired either of the WXYZ Studios Before?
*
Yes
No
How many people will be involved?
*
Is this an activity participants pay to take part in?
*
Is this activity raising funds for any cause? If yes, please specify.
*
Do you, or any of the participants, have access requirements?
*
Do you wear footwear and, if so, what kind of footwear and for what part of the activity?
*
Do you have any special requests for your hire? i.e. a quiet space, use of large set pieces, overhead rigging or large changing area for participants?
*
Will you be bringing equipment, props or materials into the space? i.e. lighting gear, additional sound equipment, staging or materials like gold leaf, body paint or markers.
*
If so, is it easy to pack this gear away and will you need to store gear at the studios between your hire periods?
*
Do you have Public Liability Insurance (min. $10million in cover)? Are you specifically named on the policy and can you provide the certificate of currency when requested? All hirers are required to present current PLI for the activity as standard, but do let us know if you need any guidance on what we require.
*
Yes
No
Other
Do you need extra time for bump-in and bump-out? If yes, please share approximate time required.
*
If your booking involves physical activity (e.g. dance, workshops) outside of standard business hours (Monday-Friday, 9am to 5pm), a person with current First Aid certification must be present. Do you have a valid First Aid certified person available for the activity?
*
Yes
No
Additional information that you would like to provide:
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