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Booking Enquiry- Samson Recreation Centre
This is a booking enquiry form only and not a booking confirmation.
Once we receive your enquiry we will be in touch regarding availability and booking process.
Alternatively to check availability contact the centre on 08 9432 9992.
Private functions are generally not permitted at the centre.
The Samson Recreation Centre is a smoke free and alcohol free venue.
Name of contact person
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First
Last
Name of organisation / hirer
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Phone
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Email
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Details of Hire
Date Required
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DD
/
MM
/
YYYY
If multiple dates please specify dates or duration ie. term 1 or ongoing or N/A
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Time Required (Start and End)
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Includes set up and take down - time booked will be charged for
Which room/s are required (tick all that are applicable)
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Full Hall
Half Hall
Meeting Room
Annex
Description/purpose of event
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Number of participants
Will an entry fee be charged?
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Please select
Yes
No
Is this a fundraising event?
*
Please select
Yes
No
Please supply any further information about your application and any additional requirements you may have.
Supporting Documents
Supporting documents e.g indemnity, approval to charge entrance fee, temporary food permit approval, security detail etc
Terms and Conditions
Public liability insurance: The City of Fremantle recommends hirers to take out public liability to protect their group from any damage or injury that may occur during their function. The City will provide a duty of care to provide a safe environment but agrees the City is not responsible unless proved negligent. If there is the potential for any damage that could have been reasonably foreseen and does occur then the City of Fremantle retains the right to pursue a claim for damages from you the hirer.
Terms and Conditions
I have read and agree to the above terms and conditions
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Yes
Signature
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Clear
Date Time
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DD
/
MM
/
YYYY
