Contract of Hire - Public Open Space

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.

Once you have submitted your form, you should receive a confirmation email. If you don't receive the confirmation email or have any further questions, please contact our Venues Support team on 08 9781 0383.

Please take the time to read through the Terms and Conditions before commencing your application.

Hire Terms and Conditions

Contact Information

Hirer Name or Organisation*

Address*

Suburb*

Postcode*

Contact Name*

Position

Email Address*

Phone Number*

Indicate which Public Open Space area you wish to hire?*

Please indicate your category of hire*

Community Group/ Registered Charity/ Not-for-Profit
Commercial Hire/ Private User/ Government

If you have a Public Liability Certificate please upload it.

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

Will alcohol be consumed?*

No
Yes (please also fill out our Application to Consume Liquor Form)

Activity being conducted*

Approximate number of attendees*

Are you planning to utilise any of the following for your booking? (Please tick all that apply)

Use of electricity/generator or access to onsite power
Food trucks or mobile food vendors on site
Temporary installation of structures (such as marquees, staging, toilets, or amusement rides)
Requesting additional bins or waste management services
Other special requirements (please specify below)

If you selected "other special requirement", please specify below

Date of hire period*

Please indicate start and finish times (including setup/packup) for each day you intend to hire the venue (ie, Monday 8am - 10am/ Tuesday 1pm - 3pm).

I acknowledge that I have read and accept the Terms & Conditions (shown at the very top of this form)*

Yes

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