Wongawilli Community Centre
Application for Hire
I wish to hire (please tick) Wongawilli Community Centre
Please note that application to the Dapto Rural Fire Service (ph 4261 7363 - fax 4261 7279) is required for the use of the Park Grounds surrounding the Hall. The boundary of the Hall is the toilets and the concrete slab at rear.
Date of Event: ______________________________________________________________________________
Type of Event: _____________________________________________________________________________
Number Attending Function (approx.) ____________ but will not exceed ____________________
Name of Hirer: __________________________________________________________________________
Suburb: _____________________________________ Postcode: ________________________
Telephone No ( ) _________ (W) ( ).__________ (H) Fax No. ( ).__________________
Please note that you or your organisation may be liable for any loss, damage or claims resulting from your use of this facility. You should consider obtaining suitable insurance.
I have read the conditions applying to the use of the Centre. I agree to abide by and be bound by those conditions.
Please note all rubbish is to be taken away or a fee of $25 can be paid for use of the Hall Bin.
Enclosed : $ _________ full hiring charge, $ _________ deposit,
$ _________ bond, $ 25 Hall Bin Fee
(Delete whichever not applicable)
Total Enclosed: $ __________
Date _____________________ Signature._____________________________________
Please return form to:
Wongawilli Colonial Dance Club Inc.
PO Box 175, Jamberoo, NSW, 2533
Enquiries: David De Santi firstname.lastname@example.org or tel: 0409 57 1788