Online Form - Application to Consume Alcohol on a Council Facility or Reserve

Application Details

Please enter the details regarding the application below.

Contact Details

Provide details of event and the proposed supply of liquor at the event, including type of alcohol which will be served:

Will any glass be used at the event?*
Will a charge or fee be imposed upon guests for entry to the event?*
Will alcohol be sold?*

If YES, the ‘Hiring Organisation’ must also obtain a function Permit/Licence from the Clerk of Courts, Hawke Place, South Hedland (Ph: 08 9172 9300) or online at

I, for and on behalf of the Hirer, agree as follows:

  1. I have read, acknowledge and agree the Hirer will be required to comply with the terms and conditions set out in the ToPH’s policy “Occasional Licences and Consumption of Liquor on a recreation reserve or council owned or managed facility” within the Terms and Conditions located on the ToPH Website;
  2. The Hirer will comply strictly with any relevant provisions within the Liquor Control Act 1988 (as amended) – to consult the full Act please visit
  3. The Hirer has developed a risk management policy or plan to ensure that alcohol is served in a responsible manner.
  4. In the event of a cyclone, approval to consume liquor may be revoked for safety reasons.

Site Plan

Please illustrate the oval/reserve you wish to hire including location/s of where alcohol will be purchased and consumed. Please include any major landmarks including goal posts, lights, car park, toilet blocks etc.

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