Online Form - Request for Hire - Kambalda Facilities

Please read the full terms and conditions here.

The Hirer must ensure current COVID safety measures and state mandates are being adhered to in relation to the facility being hired. It is the responsibility of the Hirer to ensure all attendees are fully aware of the current requirements and carry out the measures currently in place to help mitigate the spread of the virus. Please check the Shire’s online hire form for specific details.

To keep up to date with all COVID-19 requirements and event restrictions please visit https://www.wa.gov.au/government/document-collections/covid-19-coronavirus-events

APPLICANT INFORMATION (ALL FIELDS MUST BE COMPLETED)

Not-For-Profit
Maximum size of ALL attachments is 976.56 MB
Food Consumption
Caterer Details
Have you used this Facility before
Alcohol Consumption
Food Sold
Alcohol Sold
Liquor License
Will any structures be erected?
Security present
Qualified first aider onsite?
EQUIPMENT (check all required) - Items marked with an * will be at an additional cost. Equipment must be signed out at the commencement of the hire and signed back in upon completion of your booking. All items are the hirer’s responsibility and are to be set up/packed away by the hirer within the designated booking time.
FACILITIES (check all required) *
Layout /Seating
Do you agree to adhere to the terms and conditions (please see link above to download full terms and conditions.) By ticking yes, you confirm agreement with conditions.