Application to Consume Liquor » City of Busselton

The City of Busselton collects personal information to process this form and provide the requested services. Information may be used for related City business purposes or disclosed where authorised by law. To learn how your personal information is handled, access the City’s Privacy Statement or contact the Privacy Officer at privacy@busselton.wa.gov.au.

Contact Information

All applicants must be over 18 years of age

Last Name*

First Name*

Organisation (if applicable)

Street Address*

Suburb*

Postcode*

Phone Number*

Email Address*

Event Details

Booking Date*

Event Start Time*

Event Finish Time*

Event Location

Brief explanation of activity to be undertaken in venue*

Will there be a charge to attend the event?*

Yes
No

Number of adults attending?*

Number of juveniles attending?

Is this event public or private?*

Public
Private

Liquor Management

Will Busselton Police be notified of the event?

Yes
No

How will alcohol be provided?*

Sale
Supply
BYO

Time first drink will be served?*

Time last drink will be served? (Last drink should be served half an hour before the end of event)*

How have guests been invited?

Invitation
Social Media
Ticket Sales

How will intoxicated persons be managed?*

How will juveniles be recognised and managed?*

How will you control access to liquor at the event?*

Additional Information

I understand that under the Requirements of the Liquor Licensing Act 1988 Section 119(1), it is an offence to consume liquor on Council premises without the consent of the Council. I understand that hirers are responsible for contacting the Department of Racing, Gaming & Liquor to ascertain which liquor licence will need to be obtained if required.*

Yes

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