Online Form - Request for Hire - Kambalda Facilities

Please read the full terms and conditions here.

APPLICANT INFORMATION (ALL FIELDS MUST BE COMPLETED)

Not-For-Profit
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?
Days requested*
FACILITIES or PARKS (check all required)*
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.
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.