General Bookings Application Form Your Details Name of organisation:* * Required Field. Primary Contact Name:* * Required Field. Email:* * Required Field.* Please enter a valid email address Mobile:* * Required Field.* Please enter a valid mobile phone number Street Address* * Required Field. Booking Details Please provide as much detail as possible to help us plan for your event. For multiple bookings, please provide further details to bplc.bookings@vincent.wa.gov.au once you've submitted this form. Type of booking* Select an Option Commercial Community (not for profit) Internal * Required Field. Is your booking.. (please select)* Select an Option Daily Weekly Monthly School term Yearly Carnival Other One off * Required Field. Will your booking continue through school holidays? YesNo Will your booking continue on public holidays? YesNo Please Note: The centre hours may be affected by public holidays. Estimated Swimming Attendance (Adults over 16) Estimated Swimming Attendance (Children 5-15 years) Estimated Spectators (Not Swimming) Payments Students aged over 16 and concession cardholders will need to show valid ID for discounted entry. Please view our entry fees here. Invoice required? YesNo Please provide a name and email address : * Entry fees to be included on the invoice YesNo We will finalise all payments on the day (a receipt will be provided for payments made on the day) YesNo Swimmers will pay their own entry on the day YesNo Pool Hire If you are not booking pool space, please ignore this section. Please note, carnivals can only be booked on Wednesday, Thursday and Friday during Term One of each school year. Purpose of booking: (please specify): Booking start date: Booking end date: Booking start time: Booking end time: Dates to be excluded from regular booking: 50 metre Outdoor Pool: Number of lanes required Select an Option 0 1 2 3 4 5 Entire Pool (Carnivals Only) 30 metre Outdoor Pool: Number of lanes required Select an Option 0 1 2 Half Pool Full Pool 12 metre Outdoor Pool: Space required Select an Option Not Required Half Pool Full Pool 6x3m Shade Shelters required? (additional charges apply) Select an Option 0 1 2 3 4 5 6 7 8 Number of tables required (up to 8) Number of chairs required (up to 50) 25 metre Indoor Pool: Number of lanes required Select an Option 0 1 2 3 4 5 Indoor Pool Leisure Areas required LagoonSlide poolBeach rock poolGeneral leisure swim Lane ropes required? YesNo Dedicated lifeguard/s required? YesNo Additional charges apply. Room Hire If you are are not hiring any rooms, please ignore this section. Booking start date Booking end date Booking start time Booking end time Rooms required Club RoomClub Room & Outdoor BBQCycle StudioStudio 2 (subject to availability) Number of chairs required (up to 50) Number of tables required (up to 8) Whiteboard required? YesNo Projector Hire YesNo Additional Requirements Do you require a repeat booking? Select an Option Daily Weekly Fortnightly Monthly Other If other, please specify Please advise if you have any other requirements. Terms & Conditions We require all hirers to have Public Liability Insurance. Please read our Conditions of Hire before submitting this form. I am over 18 and have read, understood and agree to the Terms & Conditions:* I agree If you have it now, please attach your Public Liability Insurance documentation 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 Type the code from the image: The code you entered is not valid. Get Audio CodeType the code from the image