SOTS EVENT APPLICATION AND FACILITY HIRE FORM
APPLICANTS DETAILS
Name of Organisation:
*
Postal Address
*
Contact Person/Event Manager
*
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (08) 0000-0000.
Mobile
*
Please enter a valid phone number.
Format: (+61) 000-000-000.
Facility:
*
Community Hall
Pavillion
ECLC Consultant Room
Swimming Pool Multipurpose Room
Red Room
Other
Are you a fundraising organisation for charity or a community group?
*
Yes
No
EVENT DETAILS
Event organisers are to provide an event timeline detailing all information relevant to the event: e.g. setup and clean-up times, road closure times, erection of marquee times etc. The timeline is to be submitted to the Shire three (3) weeks prior to the event.
Type of Project / Event:
*
Private Function
Community Event
School Event
Training Course
Indoor Sports
Other
Name of Project / Event:
*
Project / Event Start Date:
*
-
Day
-
Month
Year
Start Date
Hour Minutes
AM
PM
AM/PM Option
Project / Event End Date:
-
Day
-
Month
Year
Start Date
Hour Minutes
AM
PM
AM/PM Option
Add all the dates here (if multiple sessions over a period of time)
Expected Number of Attendees - Adults:
*
Expected Number of Attendees - Children:
Will there be alcohol at the event
*
Yes
No
Alcohol cannot be consumed at the ECLC consultants room and Swimming Pool Multipurpose Room.
Liquor Permit: If you are selling alcohol, have you applied for a permit from Liquor and Gaming?
Yes
No
Liquor Permit No:
Will there be gaming at the event:
*
Yes
No
Gaming Permit: If you are playing bingo, have you applied for a permit from Liquor and Gaming?
Yes
No
Gaming Permit No:
Do you require use of the following? (Additional fees will be incurred.)
Rows
Yes
No
PA System
Furniture (tables and chairs)
Furniture Type and Quantity
Rows
Quantity
Number of Chairs
Number of Round Trestle Tables (seats 10)
Number of Rectangular Trestle Tables (seats 6)
COUNCIL OWNED PARKS
Event organisers must seek permission prior to piercing the ground with tent pegs, fencing and other forms of spikes to avoid damaging reticulation. It is recommended that the event organiser arrange an onsite meeting with the Shire’s Supervisor of Operations, Facilities and Maintenance to ensure the underground reticulation is not damaged during the event.
Are you organising the event in park land?
*
Yes
No (skip to FEES & CHARGES )
Only applicable if the activity/event is on Council owned park
Rows
Yes
No
Do you require the reticulation to be turned off? (Applicable only to events being held – including set up – between the hours of 6pm and 9am)
Do you require the reticulation to be marked? (Applicable only to events piercing the ground)
FEES & CHARGES
Please note that fees and charges are set by Council, and are not subject to negotiation. Equipment Fees are payable additional to Venue Hire Fee. Venue to be left in clean and tidy state. If not, cleaning fees will apply. For incorrect use of venue / equipment. Fee will depend on the type of damage occurred. Link to Fees and Charges: https://www.threesprings.wa.gov.au/index.php/our-council/public-documents/other-documents
Tick the following box to confirm that you understand the FEES & CHARGES statement.
*
Tick Here
Power Supply
All power cords are to be tagged and tested in accordance with the Health Act 1992 (Public Buildings).
Are you using power generators:
Yes
No
Bins
Please ensure there are adequate number of binsavailable for the expected attendees at the facility.
Do you need extra bins at the event/project location?
*
Yes
No
Please indicate numbers:
TRAFFIC MANAGEMENT
Is any part of the event is on or close to a road?
Yes
No
TRAFFIC MANAGEMENT - Please provide details of any road closures or use of roads for the event.
COUNCIL EVENT ADVERTISING
IMPORTANT: Please keep the Shire informed of any changes of times, dates and cancellation etc for your event.Please note: The Shire of Three Springs will only publish not for profit and apolitical adverts on the Community LED Sign.
Would you like your event listed on the Community LED Sign? Please review the Shire fees and charges for advertising on the LED Sign)
*
Yes (please attach flyer below)
No
Would you like your event listed in the Yakabout Newspaper? (Please review the Shire fees and charges for advertising in the Yakabout)
*
Yes (please attach flyer below)
No
Yakabout Advertisement Details
Rows
Your Answer
Please add the Yakabout Issue Number or dates here.
Yakabout Dates Link
:
https://www.threesprings.wa.gov.au/index.php/services/yakabout
Advertisement Type (Colour or Black & White)
Advertisement Size (Full Page, Half Page or Quarter Page)
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DECLARATION
You as the event organiser, seek approval to host an event, I acknowledge that the information and completed actions in my application are true and correct. I will ensure that appropriate liability, and other insurances and other licences are in place for the activities to be conducted. I understand that the Event application guide is a guide and has been compiled according to a number of statutory requirements. There could be other requirements that exist outside of the guide and that as the event organiser I am responsible.
Signature
*
Type Full Name Here
Date
-
Day
-
Month
Year
Date
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Are you selling food items at your event?
*
Yes
No
Are you preparing food at unregistered venue or setting up a food stall?
*
Yes (Please complete and submit this form)
No (Go to next page)
APPLICATION FOR STALL HOLDER’S PERMIT – FOOD
Name of Organisation/Stallholder:
Contact Person:
Postal Address:
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (+61) 000-000-000.
DETAILS OF PROPOSED STALL
Are you a registered food business? (Note – All food businesses must be registered by their local government authority (LGA), unless exempt. If your LGA is not in the Shire of Three Springs, please attach a copy of your Certificate of Registration)
Yes
No
Name of Stall:
Location of Stall:
Start Date and Hours of Operation
-
Day
-
Month
Year
Date
Hour Minutes
AM
PM
AM/PM Option
End Date and Hours of Operation
-
Day
-
Month
Year
Date
Hour Minutes
AM
PM
AM/PM Option
List of products to be sold:
TYPE OF FOOD PREPARATION/HANDLING:
Low risk – pre-made, packaged goods from a registered food business, or residential registered food business for direct sale e.g. biscuits, preserves, muffins, packaged drinks
Low/Medium risk – fresh or packaged ingredients obtained from a registered food business ready for preparation or use e.g. hot drinks, ice cream, bbq sausage sizzles, pizza
Medium/high risk – foods pre-prepared at a registered food business for onsite cooking or reheating e.g. meat curries, risotto
Please tick to confirm whether the proposed stall has the following facilities:
a roof, three walls, cleanable impervious floor (if on unsealed ground)Note: Open food stalls consisting of tables only or tables and trestles, shall be used only for the sale of factory pre-packaged food in hermetically sealed containers
a dedicated dishwashing facility with detergent and sanitiser*
a hand washing facility with running water, soap, disposable paper towels
cooking appliances
hot display
refrigerated storage/display
Power supply:
Self-contained
External
Water supply:
Self-contained
External
Waste Water supply:
Self-contained
External
REQUIRED DOCUMENTATION (as applicable).
Copy of current Public Liability Insurance Certificate – minimum cover $10,000,000
Plan of the proposed stall (including stall location)
Copy of Food Business Certificate of Registration – by Local Governments other than Shire of Three Springs
Other
Please ensure that you attach the following information with your application to assist with the processing of your stall holder’s permit in time for your event. Also attach written consent from the owner of the property (if you are not the owner).
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DECLARATION
Declaration: I, the applicant as undersigned and authorised on behalf of the above named organisation/business, agree to the conditions as attached to this form and understand this permit may be revoked at any time for breaches of the conditions, entailing the obligation to cease operations immediately.
Signature
*
Type Full Name Here
Date
-
Day
-
Month
Year
Date
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Are you setting up a stall to sell Non-food items on Thoroughfares and/or and Public Places within the Shire of Three Springs?
*
Yes (Please complete and submit this form)
No
APPLICATION FOR STALL HOLDER’S PERMIT – NON-FOOD
Activities on Thoroughfares and Trading in Thoroughfares and Public Places Local Law 2000Applications must be lodged at least 14 days prior to the event, or they may not be processed in time.
Name of Organisation/Stallholder:
Contact Person:
Postal Address:
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (+61) 000-000-000.
DETAILS OF PROPOSED STALL
Name of Stall:
Location of Stall:
Start Date and Hours of Operation
-
Day
-
Month
Year
Date
Hour Minutes
AM
PM
AM/PM Option
End Date and Hours of Operation
-
Day
-
Month
Year
Date
Hour Minutes
AM
PM
AM/PM Option
List of products to be sold:
REQUIRED DOCUMENTATION (as applicable).
Copy of current Public Liability Insurance Certificate – minimum cover $10,000,000
Plan of the proposed stall (including stall location)
Other
Please ensure that you attach the following information with your application to assist with the processing of your stall holder’s permit in time for your event. Also attach written consent from the owner of the property (if you are not the owner).
Browse Files
Drag and drop files here
Choose a file
Cancel
of
DECLARATION
Declaration: I, the applicant as undersigned and authorised on behalf of the above named organisation/business, agree to the conditions as attached to this form and understand this permit may be revoked at any time for breaches of the conditions, entailing the obligation to cease operations immediately.
Signature
*
Type Full Name Here
Date
-
Day
-
Month
Year
Date
Save
Submit
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