Application for Room Hire Address: PO Box 1667, Caboolture, QLD 4510 Reception Ph: 5495 3818 Room Hire Ph: 5495 7556 Internet: www.caboolturenhc.com.au email: admin@caboolturenhc.com.au Fees listed are applicable 1 July 2022 - 30 June 2023 ABN: 78 155 350 847 Applicant DetailsName of group/organisation: Non for profit organisation:Please SelectYesNoContact Name: First Last Business Phone Number:(Required)Email address:(Required) Address Street Address Suburb State Postcode Room Details Room Title Description Training Room Tables & seating for Max 16 people, airconditioned with small fridge & urn. PLEASE NOTE: Not suitable for wheelchair access – 4 steps up to the door. Conference Room (Building B) Tables & seating for Max 16 people, airconditioned with access to main communal kitchen area & toilet. Playground Room (Building A) Outdoor undercover area including children’s gated playground for Max 16 people. Access to main communal kitchen and toilets through Alcove Board Room (Building A) Table & seating for Max 16 people, airconditioned with access to kitchen & wheelchair accessible toilet. Entry to room through reception. Office Office space can be available – various sizes. Availability limited. *Alcove This space is the walkthrough between the Playground Room and the Conference Room. If you require extra space with a Conference Room booking AND the Playground Room is NOT in use, this area may be booked exclusively. There is a ‘soundproof’ sliding wall to block the area off. General Hire: Room Title Per hour full rate Half day full rate Full day full rate Training Room $25.00 $75.00 $150.00 Board Room $25.00 $75.00 $150.00 Conference Room $20.00 $60.00 $120.00 Playground/Room $20.00 $60.00 $120.00 Office $20.00 $60.00 $120.00 *Alcove Non for Profit Organisation Fees Room Title Per hour full rate Half day full rate Full day full rate Training Room $15.00 $40.00 $80.00 Board Room $15.00 $40.00 $80.00 Conference Room $10.00 $35.00 $70.00 Playground/Room $10.00 $35.00 $70.00 Office $10.00 $35.00 $70.00 *Alcove Booking Details:Room Name:Please SelectTraining RoomBoard RoomConference RoomPlayground/RoomOffice*AlcoveDate Required: DD slash MM slash YYYY Start Time: : AM PM AM/PM Finish Time: : AM PM AM/PM Number of people to attend:Please enter a number from 1 to 16.*Please be aware of the Max people limits listed aboveName of Booking Equipment Required: 55" flat screen TV with HDMI cables Whiteboard WiFi Are you a casual hirer? (i.e. do not hire our venue more than 5 times a year) and do not have public liability insurance? Yes No Please attach a current Certificate of Currency from your public Liability Insurer – this is essential.File UploadMax. file size: 200 MB.I/We On behalf of (Club/Organisation) Hereby acknowledge having read and understood the conditions of hire and agree to be bound by and comply with all these conditions. I/We further agree to be responsible for ensuring that all individuals or groups using the premises in association with this event shall comply with the conditions of hire. I/We agree to indemnify the Caboolture Neighbourhood Centre from, and in respect to, all actions, suits, claims, or demands of any kind arising out of, or relating to, the hire and use of the facility owned by Caboolture Neighbourhood Centre in respect of any activities undertaken by us, or any other party involved. Signature(Required) Please note: Signatory must be over 18 years of age. Date DD slash MM slash YYYY Caboolture Neighbourhood Centre is collecting your personal information for the purpose of assessing your application for room hire. The collection of this information is authorised under the local Government Act 2009. Your information will not be given to any other person or agency unless you have given us permission, or we are required by law. Terms and Conditions of Hire: All equipment and/or dishes used by groups must be returned to storage areas and/or loaded into the dishwasher. As we do not employ cleaners every day, it is essential that groups leave the rooms clean and tidy and remove any rubbish resulting from your activities. Any additional cleaning required will result in a charge of $50.00. Any breakages of the Centre equipment is to be reported IMMEDIATELY to reception or a volunteer on duty, or if out of hours please report to the Centre reception ASAP via email or phone. Groups are requested to bring your own tea, coffee, sugar and milk otherwise a fee of $2.00 per person will be charged. Please ensure when leaving that all lights, fans, air-conditioner, audio, and visual equipment have been turned off and where appropriate, disconnected. For after hours bookings the alarm system must be de-activated upon entering and activated when leaving. Failure of either of these will result in a charge of $160.00. Website/Facebook AuthorisationDo you wish to be added to website and Facebook page? Yes No *Please note that the Caboolture Neighbourhood Centre reserves the right to not include or to remove anyone from the site and or Facebook page at any time. COVID 19: When coming to the Centre, we ask that you abide by the current Queensland Government guidelines:https://www.covid19.qld.gov.au