______Booking______Event Name Venue Booking start date 215 High Street Email: [email protected] Private Bag 1005 Phone: 0800 965 468 7440 waimakariri.govt.nz New Zealand HALL BOOKING APPLICATION FORM (NOT TO BE USED FOR BOOKING THE RANGIORA TOWN HALL, WOODEND COMMUNITY CENTRE OR RUATANIWHA CIVIC CENTRE)

Name of Hall: __ Reserve booked: Y / N Name of Organisation: ______Name of Person Arranging Booking: ______Address for Contact: ______

Name & Address for Invoice (if different to above):______Telephone:(Home) (Work) ______Mobile: Email Address: ______Purpose of booking: ______Number of people expected:

Type of booking: COMMUNITY COMMERCIAL PRIVATE INDIVIDUAL Dates and Times of Booking: ______

For Recurrent Bookings, list exception dates if any. All dates not specified will be charged.

______Please tick the relevant fields below that apply to your booking and include additional details. Public Event ______High levels of attendance/crowds ______Use of entertainment equipment (Eg, bouncy castles/tents/fun-fair equipment)______Use of electrical equipment (Eg, leads/sound system etc) ______Alcohol  BYO Supplied Sold  Included in ticket charges Other ______A Health and Safety Plan will be required in most cases when one or more of the above has been ticked.

Health and Safety Plan Required, to be submitted and approved a minimum of 10 working days before the event. The booking confirmation is void without this approval. Link to website template: https://www.waimakariri.govt.nz/__data/assets/pdf_file/0019/16534/Event-HS-plan-Template-example.pdf Please call 0800 965 468 if you require help from a Greenspace Officer to complete this.

If there will be Alcohol at the event, other than BYO for a private function, a special licence may need to be applied for through the Council Environmental Services Unit, please refer to our website https://www.waimakariri.govt.nz/services/environmental-health-licensing/alcohol-licensing/special-

Please complete the following page

160205009538 Page 1 of 7 Waimakariri District Council QS_R382-AB Issue 16 updated July 2017 Hall Booking Application Form / Emergency Evacuation Procedures Please Note:  NO STILETTO HIGH HEELS are to be worn in the FERNSIDE and WEST HALLS due to the damage they can cause to the Rimu flooring.  FERNSIDE HALL KEY also works on the adjacent carpark lock. If using the car park outside school hours, it is the hirer’s responsibility to ensure the car park is empty and locked at conclusion of the booking.

Special Requirements: ______

CHARGES: Booking Fee Per Hour: ______Total Cost: ______

The attached Emergency Evacuation Procedures have been read, understood and are hereby accepted.

Name of Chief Fire Warden/Safety Officer : ______

Fire Warden/ Safety Officer to Sign: ______Date: ______

The attached Conditions of Hire have been read, understood and are hereby accepted.

Name of Applicant: ______

Applicant to Sign: ______Date:______Please Note: By entering your name above you are giving your authority for this application to proceed

OFFICE USE: Booking entered (on computer) as TBC Debtor # Booking requirements advised by Greenspace Booking confirmed Booking confirmation sent to applicant Booking confirmation sent to Greenspace email Trimmed Payment received, Receipt number: ______Date: ______H&S Plan approved by: ______Date: ______

CANCELLATION DATES (Attach written details): ______

Confirmation actioned by: ______Checked by: ______

160205009538 Page 2 of 7 Waimakariri District Council QS_R382-AB Issue 16 updated July 2017 Hall Booking Application Form / Emergency Evacuation Procedures

CONDITIONS OF HIRE 1 . ACCESS TO VENUES - KEYS

• Venues have a key system. Keys can be collected the day of the hire from the Waimakariri District Council service desk on receipt of payment. • If the hire is over the weekend, the key is to be picked up on the Friday prior to the booking. • There will be a charge of $20.00 if the key is not returned on the next business day or as otherwise arranged. • Commercial, Government and recurring bookings may have an invoice or key agreement.

2 . RIGHT OF ENTRY

Waimakariri District Council reserves the right for Waimakariri District Council staff on presentation of an authorised warrant to be present at the venue at any time. Any Councillor or Hall Advisory Group member on Waimakariri District Council business may enter the venue at any time.

3 . HIRE CHARGES

• All hire charges and other fees for the use of the venue shall be paid in advance, invoicing can be arranged prior to the booking in some instances such as recurrent or government bookings. • The Waimakariri District Council reserves the right to cancel the booking if any unforeseen circumstances arise after the booking has been confirmed. • The Waimakariri District Council reserves the right to cancel any bookings at its sole discretion without liability for any loss or additional costs incurred by the hirer or payment of compensation to any party whatsoever. • Should a request for a booking be made at a time and/or venue that conflicts with another booking the Waimakariri District Council reserves the right to determine which hirer shall be given use of the venue at its sole discretion.

4 . ADDITIONAL COSTS

Additional Costs will occur if: • Venue equipment or fittings are damaged. • Extra cleaning is required. • You enter into or remain in the venue outside the booked period. • The keys to the venue are not returned within the stated time. • Rubbish is left inside or outside of the venue. • Any other breach of these conditions has occurred, resulting in call out charges or other costs to the Waimakariri District Council. Should additional costs for venue repair, cleaning or any other reason be incurred by the Waimakariri District Council in relation to the hire the hirer will be responsible for reimbursing Waimakariri District Council for those additional costs within 14 days of being advised of those costs unless otherwise agreed to by the Waimakariri District Council in writing. The base minimum charges for extra cleaning & rubbish removal is $75.

5 . CANCELLATION/ADDITIONAL BOOKINGS

Once confirmed, ten working days notice in writing shall be given for all cancellations, change of bookings and times. • Waimakariri District Council reserves the right to levy the full rental costs for venues cancelled less than 10 days prior to the event. • Waimakariri District Council reserves the right to charge a cancellation fee of 50% if the hirer cancels the booking once the booking has been confirmed. • A charge may also apply when a booking time and date is changed after a booking is confirmed.

6 . HEALTH AND SAFETY

Hirer’s responsibilities: • Carry out a “facilities pre-use check”. Familiarise yourself with the evacuation sheet for the venue. • Act as the building warden. • Verify the position of all exit points and stairways and confirm these are not obstructed. • Be present for the duration of the hire. • Supply Health and Safety Plan if required. • Ask for help if you do not understand these responsibilities.

7 . CLEANING AND RUBBISH REMOVAL

• Hirers are responsible for the cleaning of the venue. • Hirers must supply their own dish washing liquid and tea-towels. • Chairs and tables must be wiped down and returned to the original location. • The cleaning of the venue must be completed at the end of the event, unless prior arrangements have been made. • Hirers must remove all rubbish from the venue and grounds after their hire.

8 . FIRE/ EVACUATION RESPONSIBILITIES

• Every hirer is required to be familiar with the procedure for evacuation in the Emergency Evacuation Procedure. • The appointed fire warden must ensure that all means of egress are checked at the start of the hire period and control and supervise the venue evacuation procedure. • In the event of a fire evacuate the venue immediately then notify the Fire Brigade by phoning 111. • When the venue is safely evacuated, contact the Waimakariri District Council on 0800 965 468. 160205009538 Page 3 of 7 Waimakariri District Council QS_R382-AB Issue 16 updated July 2017 Hall Booking Application Form / Emergency Evacuation Procedures

9 . HIRE CONTRACT

The hirer’s contract must be signed by a person 21 years of age or over and returned to the Waimakariri District Council office at least 7 days before the hire date to allow time for confirmation. Identification may be requested.

10 . HOURS OF USE

• Hirers may not enter any facility until the time booked for the function and must be out of the facility by the end of hire. • The booking period must include set up and cleaning of the venue.

11 . CONCLUSION OF ACTIVITIES

If the Hall is hired for an evening function, music is to be turned off by midnight and activities must cease no later than 1am, unless prior approval is granted by the Waimakariri District Council. Some Waimakariri District Council venues have earlier finishing times. Cleaning may be carried out after these hours, if required.

12 . ALCOHOL

• The hirer must specify and request permission for the consumption of alcohol at the time of making the booking. • If liquor is to be sold an application to the Waimakariri District Council Environmental Services Unit for a Liquor Licence for the sale of alcohol is required.

13 . PROHIBITED

• No smoking in the venue. • No chewing gum in the venue. • No use of confetti or glitter. • No decoration or scenery may be attached to or hung from the venue without prior written permission from the Waimakariri District Council. • No open fires, smoke machines, naked flame barbecues or spits are to be used inside any venue without prior written permission from the Waimakariri District Council. • If a fire alarm is set off by the user, a charge will be incurred.

14 . NOISE

Noise from amplifiers and loudspeakers must be kept to a moderate level at all times. Failure to comply with this condition may result in the early closure of your function and a fine. Contravention of an excessive noise direction under section 327 of the Resource Management Act 1991, Section 338(2)(c) is a $500 fine.

15 . DAMAGE TO THE HALL OR FIXTURES

• Any damage to the hall or fixtures or breakages must be notified immediately to the Waimakariri District Council by the hirer. Phone 0800 965 468. • The hirer is responsible for the full cost of any damage.

16 . SECURITY

The hirer is responsible for securing the venue upon completion of the function. Ensure: • All lights, heaters, stoves and electrical appliances are turned off. • Windows and doors are closed and locked. • Alarm is set (where applicable). A security guard may be required to attend all functions involving alcohol, night time socials or at the discretion of the Waimakariri District Council. The prime purpose of the guard is the protection of the venue and to ensure event times are adhered. The guard may be used for event security as a secondary function where it does not interfere with their prime purpose. The hirer is responsible for providing the security guard when one is required.

17 . BREACH OF CONDITIONS

Any breach of the Conditions of Hire may result in: • Closure of the function. • Refusal to accept future bookings. • Extra charges being incurred.

18 . PUBLIC LIABILITY INSURANCE

The hirer is responsible for public liability insurance. Insurance of $1,000,000 is recommended by the Waimakariri District Council. If your group/organisation does not already have its own insurance, the Waimakariri District Council insurance brokers, Jardine Lloyd Thompson, has group facility insurance available at a very competitive rate. Should you wish to utilise this insurance please contact Nicola Frayle at Jardine Lloyd Thompson Ph 0800 111 644.

160205009538 Page 4 of 7 Waimakariri District Council QS_R382-AB Issue 16 updated July 2017 Hall Booking Application Form / Emergency Evacuation Procedures

COMMUNITY BUILDINGS AND HALLS EMERGENCY EVACUATION PROCEDURES

NAME OF BUILDING

Duties of Wardens

Prior to Opening

 A Chief Warden is to be appointed by each group hiring this facility (and deputy if 50+ occupants) who must clearly understand their duties

 Familiarise yourselves with the location of the assembly point (refer to evacuation map located next to extinguisher)

 Ensure the evacuation routes are clear of obstructions and that the exit doors can be easily opened. No flammables to be stored near escape routes

 Familiarise yourselves with the location of emergency warning systems and fire extinguishers (being careful not to activate the extinguisher)

 Identify those persons requiring evacuation assistance on the Chief Warden’s Evacuation Report

160205009538 Page 5 of 7 Waimakariri District Council QS_R382-AB Issue 16 updated July 2017 Hall Booking Application Form / Emergency Evacuation Procedures

IN THE EVENT OF A FIRE

-Wardens Duties-

1. ACTIVATE ALARM AND PHONE 111

2. ENSURE EVERYONE VACATES THE BUILDING

3. ASSIST ANY PERSONS WITH DISABILITIES

4. WARDEN’S CHECKS SHOULD BE COMPLETED AS QUICKLY AS POSSIBLE TO AVOID PERSONAL RISK

5. REPORT TO DESIGNATED ASSEMBLY AREA

6. PASS ON THE EVACUATION REPORT TO THE FIRE SERVICE ON THEIR ARRIVAL

7. STOP RE -ENTRY OF PERSONS UNTIL THE ‘ALL CLEAR’ HAS BEEN GIVEN BY THE FIRE SERVICE

160205009538 Page 6 of 7 Waimakariri District Council QS_R382-AB Issue 16 updated July 2017 Hall Booking Application Form / Emergency Evacuation Procedures Name of Building Evacuation Report (Preliminary completion of shaded boxes by meeting organiser as Chief Warden and if evacuation required. Evacuation Report to be handed to Fire Service on arrival.)

Disabled Zone Clear? Zone Occupant Warden 1 Warden 2 Occupants? (Tick Box) How many?

Chief Warden Assigned Main Hall / Public (e.g. meeting Deputy (when

Function Room organiser) 50+ persons)

Kitchen Toilets Chief Warden Assigned (e.g. meeting Deputy (when Store Room Public Meeting/Supper organiser) 50+ persons) Rooms

Other Rooms Identified Assigned Public Deputy (when 50+ persons)

NOTES: o Do not turn off lights o Do not lock any doors o Do not attempt to put out fires unless the fire is small and manageable, and you are familiar with the use of the equipment provided o Contact Waimakariri District Council – phone 0800 965 468 (24 hours)

Observations (Number of disabled occupants / Location of Smoke / Fire / Smell etc)

160205009538 Page 7 of 7 Waimakariri District Council QS_R382-AB Issue 16 updated July 2017 Hall Booking Application Form / Emergency Evacuation Procedures