Application for re-occurring
facility hire
I, __________________________________________________________________________ (applicant’s full name)
of _____________________________________________________________________ (applicant’s postal address)
on behalf of ____________________________________________________________________________________
(Name of organisation – if applicable)
wish to conduct a ___________________________________________________________________ (function type)
for approximately __________ persons AND for approximately __________ horses (if applicable)
Name of venue __________________________________________________________________ (hall/pavilion/oval)
Note: Horses and livestock are only permitted on Serpentine Sports Ground. In this case a ground surface fee of $10
per horse, per event is charged. Applicants are to advise the Shire of how many horses attended the event and the
applicant will be invoiced accordingly.
Date From: ________________________ Date To: ________________________
Day: ______________ Time ___________am/pm to ____________am/pm
Day: ______________ Time ___________am/pm to ____________am/pm
Day: ______________ Time ___________am/pm to ____________am/pm
Applicant contact number: ___________________________ Applicant email: ______________________________
Please specify dates within the hire period where you will not be using the hall ie public holidays, school holidays etc.
______________________________________________________________________________________________
______________________________________________________________________________________________
Please note:
 Any changes to regular bookings must be advised in writing
 Facility hire and a liquor permit will only be granted to persons over 18 years (identification may be required)
 If liquor is to be consumed at the Council facility, an application must be made for a Liquor Permit. Further
information is available at the Shire Administration Centre
SIGNATURE ____________________________________
By signing this form, I have read and agree to the Facility Hire - General Conditions as outlined below.
Please return the completed and signed application form with payment to secure your booking. Bookings are
per financial year and must be renewed at the end of each financial year. Once this form has been submitted,
the Shire will confirm the availability of the facility and notify you of the costs of hire based on the information
submitted and the facility hire fees and charges.
Shire use only
⃞ Fees received …../…./….
Receipt no: ______________
⃞ Confirmation letter sent
⃞ Booking confirmed in Synergy
⃞ Bond received …./…./….
Receipt no:___________
⃞ Liquor licence sighted (if required)
⃞ Bond refunded …./…./….
Receipt no:______________
Invoice issued for horse events …./…./….
Serpentine Jarrahdale Shire, 6 Paterson St Mundijong 6123 t: 08 9526 1111 f: 08 9525 5441 w: sjshire.wa.gov.au e: info@sjshire.wa.gov.au
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Facility hire - fees and charges
Price
Inclusive GST
Hall & Pavilion Hire Fees & Charges
Byford Hall, Briggs Park Pavilion, Bruno Gianatti Hall, Clem Kentish Hall, Eric Senior Pavilion,
Mundijong Pavilion and Oakford Community Centre
Halls & Pavilions Hire Fees & Charges – Corporate or Commercial Groups
Hall Hire - Daytime use (before 6pm)/hrly rate
Hall Hire - Evening use (after 6pm)/hrly rate
Kitchen/Bar – (with Hall hire) Daytime & Evening hrly rate
Kitchen/Bar – (without Hall hire) Daytime & Evening rate
Meeting Room/hourly rate
*Bonds apply – see below
37.50
50.00
13.00
20.00
32.00
Halls & Pavilions Hire Fees & Charges - Private Use
Hall Hire - Daytime use (before 6pm)/hrly rate
Hall Hire - Evening use (after 6pm)/hrly rate
Kitchen/Bar – (with hall hire) Daytime and Evening hrly rate
Kitchen/Bar – (without hall hire) Daytime and Evening hrly rate
Meeting Room/ hourly rate
*Bonds apply – see below
33.00
43.00
13.00
20.00
25.00
Halls & Pavilions Hire Fees & Charges - Local Community Groups
Hall Hire - Daytime use (before 6pm)/hrly rate
Hall Hire - Evening use (after 6pm)/hrly rate
Kitchen/Bar – (with hall hire) Daytime & Evening hrly rate
Kitchen/Bar – (with no hall hire) Daytime & Evening hrly rate
Meeting Room / hourly rate
*Bonds apply - see below
25.50
33.00
13.00
12.10
20.00
Bonds
Bond (Briggs Park Pavilion/Eric Senior Pavilion/Oakford Community Hall
Bond - Sale/Consumption of Alcohol (Briggs Park Pavilion/Eric Senior
Pavilion/ Oakford Community Hall Clem Kentish Hall Bruno Gianatti Hall Byford Hall)
Bond (all other halls/pavilions)
Bond - Sale/Consumption of Alcohol (all other halls/pavilions)
700.00
1200.00
500.00
700.00
Permits
Liquor Permit - Single Event Only
21.00
LIQUOR & GAMING PERMITS. PLEASE CONTACT DEPARTMENT OF
RACING, GAMING & LIQUOR (www.rgl.wa.gov.au)
It is the responsibility of the hirer to ensure that the necessary liquor and
Gaming permits are obtained prior to the scheduled event.
Serpentine Jarrahdale Shire, 6 Paterson St Mundijong 6123 t: 08 9526 1111 f: 08 9525 5441 w: sjshire.wa.gov.au e: info@sjshire.wa.gov.au
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Facility hire - fees and charges
OVALS/SPORTING FACILITIES - CASUAL HIRE - Corporate/Private
Ovals
Mundijong change rooms and oval
Briggs Park change rooms and oval
Briggs Park change rooms only
Jarrahdale oval
Serpentine sports ground (Karnup Road)
Serpentine Oval (located next to Clem Kentish Hall)
NB: Horses & Livestock are only permitted on Serpentine Sports Ground
Price
Inclusive GST
375.00
335.00
335.00
81.00
295.00
381.00
300.00
OVALS/SPORTING FACILITIES - CASUAL HIRE - Community/Local Groups
Ovals
Mundijong change rooms and oval
Briggs Park change rooms and oval
Briggs Park change rooms only
Jarrahdale oval
Serpentine sports ground (Karnup Road)
Serpentine Oval (located next to Clem Kentish Hall)
219.00
254.00
254.00
63.00
219.00
300.00
219.00
EQUESTRIAN EVENT – per event
Grounds surface fee – per horse attending event
NB: Horses & Livestock are only permitted on Serpentine Sports Ground
10.00
Oval Bonds
All hires, including season bookings, to pay a bond of $350.00 to cover cost of cleaning and/or damage. This is to
be refunded if the grounds are left in a satisfactory condition.
FACILITIES AND MAXIMUM OCCUPANCY RATES:
Byford Hall – 300 people, Briggs Park Pavilion – 300 people, Bruno Gianatti Hall – 200 people, Clem Kentish
Hall – 200 people, Eric Senior Pavilion – 150 people, Mundijong Pavilion – 286 people, Oakford Community
Centre – 100 people
Serpentine Jarrahdale Shire, 6 Paterson St Mundijong 6123 t: 08 9526 1111 f: 08 9525 5441 w: sjshire.wa.gov.au e: info@sjshire.wa.gov.au
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Facility hire - general
conditions
Current Details
Please provide the Shire with details of your current committee members including position and contact
telephone number/s.
Bookings
When the Hirer requests a booking, the Shire will acknowledge the request in writing.
Cancellation
If a hirer cancels the booking four weeks prior, then a full refund is to be made. If a hirer cancels less than four
weeks prior, 25% of the charge is to be retained by the Shire and the balance refunded.
Payment
For the booking request to be confirmed by the Shire, full payment of the hire fees must be made. Payment may
be made by credit card, cash or cheque (payable to Serpentine Jarrahdale Shire). Credit card payments may be
made by telephoning 9526 1111 (8.30am to 4.25pm weekdays).
Purchase orders will be accepted from
government departments for the hire fees - an invoice for the hire fees will be sent upon receipt of the purchase
order.
Bond
The bond must be paid in full prior to the function, either by credit card or cash. There is also a $50 charge for
the key which will be returned when the key is returned. The bond will be refunded if the facility is left in an
undamaged, clean and tidy condition and the key is returned. If any additional cleaning or repair due to damage
or replacement of missing/stolen items is necessary as a result of hiring, then part or whole of the bond will be
retained and any costs over and above the bond will be incurred by the Hirer. The Bond will be held by the Shire
until any dispute (if any should arise) has been resolved. The Shire will also issue an invoice for any outstanding
costs over and above the bond that has been paid.
Security
The Hirer is responsible for securing the premises and ensuring that all lights and appliances are turned off and
all external doors are locked. In the event the Hirer does not properly secure the building (or cause false
alarms), any costs to recover security call out charges, repair to damaged items or replacement of stolen items
will be borne by the Hirer. If security staff are required for any function the costs of such a service will be borne
by the Hirer.
Damage to Building & Equipment
The Hirer is responsible for any damage or loss to the building, equipment or collection that may occur while the
Centre is under hire and undertakes to promptly compensate the Shire upon request should damage occur.
Also refer “Security”.
Serpentine Jarrahdale Shire, 6 Paterson St Mundijong 6123 t: 08 9526 1111 f: 08 9525 5441 w: sjshire.wa.gov.au e: info@sjshire.wa.gov.au
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Facility hire - general
conditions
Use of Equipment
Information as to the equipment available at each facility is available from the Shire Administration Centre upon
booking (and is available without extra charge). If additional equipment is required please enquire at the time of
booking whether this is available. If not, the Hirer must obtain the equipment at their own cost.
Room Set Ups and Furniture
The Hirer is to return all furniture at the facility to the position in which the furniture was found upon entry.
Kitchen Facilities and Catering
Hirers using the kitchen must supply their own food, beverages, tea towels, crockery, cutlery and glassware.
The kitchen is to be left clean and tidy with all bench tops wiped down and all dishes must be washed, dried and
returned to the area they were removed from, or the dishwasher stacked and unstacked. An additional fee for
cleaning will apply if these conditions are not adhered to.
Liquor Licence
If alcohol is to be consumed on the premises, a Liquor Licence must be obtained by the Hirer and must be
submitted to the Shire at least fourteen (14) days prior to the function. For further information the Hirer must
contact the Department of Racing, Gaming and Liquor (WA).
Noise Levels
Noise levels should be kept to an acceptable level and people residing nearby must be considered at all times.
If noise monitors have been placed on site these must not be interfered with.
Displays, Signage and Decorations
The Hirer must not affix anything that will have a structural impact to any surface of the facility.
Deliveries, Storage and Removal
The facilities have limited available storage space. The Shire will not accept liability for any damage or loss to
goods left or stored in the facility prior to, during or after an event.
Smoking
All Shire facilities are smoke free – smoking is not permitted inside any facility or within five (5) metres of any
entry/exit.
Parking
All parking is to be in accordance with the relevant by-laws and road rules.
Prohibitions
The use of smoke machines, dry ice machines and special effects are prohibited at all times. No flammable
liquids or other dangerous substances shall be brought to any facility. No live ammunition, gunpowder or
fireworks shall be brought to any facility.
Serpentine Jarrahdale Shire, 6 Paterson St Mundijong 6123 t: 08 9526 1111 f: 08 9525 5441 w: sjshire.wa.gov.au e: info@sjshire.wa.gov.au
E12/5367
Facility hire - general
conditions
Good Order
The Hirer shall be responsible for the full observance of these conditions and for the maintenance and
preservation of good order at the facility and the immediate surrounds throughout the duration of the hire.
Disclaimer
It is a condition of booking that all hirers conform to directions issued to them by Shire staff. The Shire, its
employees, servants and agents, shall not be held responsible for any loss, damage or injury (fatal or
otherwise), to property or person.
Maintenance Requirements
The Shire may close any facility at any time with limited notice provided to conduct maintenance.
Insurance
The Shire has public liability insurance which covers all casual hirers. Seasonal hirers are expected to have
their own Public Liability insurance.
Termination clause
Council may terminate a request for hire should these provisions not be complied with. The hirer shall not be
entitled to a refund on any amount paid to the Shire for the hire of the facility or property, or any part thereof and
the Shire shall not be responsible for any loss or damage, which may have been occurred as a result.
CHECKLIST UPON LEAVING THE FACILITY
 All floors are swept/vacuumed and/or washed
 Any stains on carpet areas cleaned
 All tables and chairs cleaned if required and chairs stacked
 All furniture replaced as found
 All appliances turned off before leaving
 Stove / oven / fridges to be removed of food
 Urn to be emptied
 Heating / air conditioning / fans turned off
 Lights are turned off (note - exit lights automatically turn on after dark)
 All rubbish from the function is to be removed
 All windows must be checked and locked before leaving
 Blinds to be drawn open at the end of the function
 All external exits secured and locked before leaving
 Alarm activated (if applicable)
 Equestrian events - all manure and hay is to be collected and removed from the site and any holes created on
the reserve are to be filled in
Serpentine Jarrahdale Shire, 6 Paterson St Mundijong 6123 t: 08 9526 1111 f: 08 9525 5441 w: sjshire.wa.gov.au e: info@sjshire.wa.gov.au
E12/5367
Facility hire - emergency
procedures
DIAL 000 IN AN EMERGENCY (FIRE / POLICE / AMBULANCE)
Shire Building Maintenance Officer: 0408 093 091
Local Police: 9526 1900
1
2
UPON ARRIVAL AT THE FACILITY
 Take note of the location of exits, fire alarms and potential (safe) outdoor assembly area.
 Note that the facility being hired may have a formal emergency plan
 Note how many persons are in attendance at the facility
EMERGENCY PROCEDURES - IN CASE OF FIRE AND/OR EXPLOSION
 Activate alarm (if fitted). Where there is no automatic alarm fitted in the centre, the hirer or lease
holder will be required to initiate an evacuation by the use of loud, clear voice commands.
 Ensure the safety of people, attend to injured persons.
 Evacuate building by nearest exit.
 Attempt to fight the fire with the appropriate fire extinguisher if it is safe to do so and the operator is
trained and competent in its use.
Prepare to give the following details to emergency services:
Name of Facility: _________________________________________
Nearest cross road: _________________________________________




Assemble outdoors at a predetermined safe assembly area (Note: avoid car park areas, move away
from any structures, avoid powerlines or known utility services locations such as gas and water
mains).
Conduct a head count.
Do not re-enter the building or its immediate vicinity.
Advise Council of the fire at the earliest possible convenience.
3
OTHER EMERGENCIES (VIOLENCE, PHYSICAL THREATS, ETC)
 Contact appropriate Emergency Service.
4
IN CASE OF EARTHQUAKE OR SEVERE STORM / CYCLONE
 Stay indoors.
 Take shelter - under tables, doorway, etc.
 Stay away from windows, overhead fittings etc.
 Wait for instructions from responding Emergency Services.
5
IN CASE OF A BUSHFIRE IN THE IMMEDIATE AREA
 Stay indoors.
 Monitor the situation.
 Do not leave the facility unless it is immediately threatened or as instructed by Emergency Services.
6
FIRST AID RESOURCES
Please note that it is the responsibility of the hirer to provide a first aid kit.
Serpentine Jarrahdale Shire, 6 Paterson St Mundijong 6123 t: 08 9526 1111 f: 08 9525 5441 w: sjshire.wa.gov.au e: info@sjshire.wa.gov.au
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