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Online Form - Additional Hire Application Form


Please tick which facility / facilities you would like to use:

South Hedland

Port Hedland

Additional Hire Details

Is access to the building(s) required, e.g. for toilets / change rooms?*

If yes, Hirer must provide an additional $50 bond for each key provided.

Have you provided a copy of your Public Liability Insurance Policy?*

All Hirers must have public liability insurance to the value of $10 million. The insurance must note the ToPH as an interested party. Hirers must provide the ToPH with copies of their current insurance policy at the time of making this Application. Sports groups may be able to obtain this insurance certificate from their State Sporting Association.

Is this event an under 18's event?*
Will overhead lighting be required?*

If yes, please indicate requirements in the table below. The use of the lights will be charged in accordance with the ToPH’s Schedule of Fees and Charges 2015/16.

Will alcohol be consumed at training or games?*

If yes, please complete the attached “Application to Consume Liquor on Council Facility or Reserve.”

Is alcohol being sold at training or games?*

If yes, it is the hirer’s responsibility to obtain the appropriate licence from the Department of Racing, Gaming and Liquor through the Clerk of Courts, Hawke Place, South Hedland. A copy of the licence must be submitted to the ToPH with this application prior to the commencement of the hire period.

Will food or drinks be sold/supplied at training or games?*

If yes, please complete attached ‘Temporary Food Premises Application Form.’ A fee will be charged in accordance with the ToPH’s Schedule of Fees and Charges 2015/16.

Requirements Table

Please note:

  • Only training details to be provided in the table below (please provide fixtures to inform us of game details).
  • When completing the table below please ensure you list all teams including second sides and junior teams.
  • This needs to include all pre-season training.

Download the form here to complete, then upload using the Upload functionality below.

Please ensure the times provided reflect actual use (training/games) so the ToPH irrigation schedule can be accurately and efficiently planned around sporting requirements.

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

Booking Confirmation Details

Booking confirmation

No booking will be confirmed until the completed application form and required documents have been returned to and assessed by the ToPH, and the appropriate hire fee and bond have been paid. If the booking is accepted, the ToPH will issue a confirmation letter to the Hirer.

Refusal or Termination of Booking

The ToPH reserves the right to refuse any application. Failure to comply with requirements set out in this document will be regarded as a breach of the hire agreement, giving the ToPH the right to recover any amount due in respect of such breach and/or cancel any future bookings. The ToPH reserves the right to determine the cost of any damage/s and/or extra cleaning.

I have read the terms and conditions and agree*

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