Application for Use of Grounds Clutha District Council Balclutha Form to be sent to: Community Facilities Supervisor, Clutha District Council Name of Organisation: Contact Person: Postal Address: City / Town: Post Code: Phone: Cellphone: Email address: Name of organisation and address for account (if different from above): SPORT/EVENT: DATE AND TIMES REQUIRED: Field Required Field Reference Required? Show ring Area 1 YES/NO Grandstand Seating: YES/NO Rugby Ground (Old show ring by Area 2 Amenities Under The YES/NO YES/NO riverbank) Grandstand: Football Ground No 1 Area 3 (Ground near Glasgow Street) YES/NO Riverside Reserve Grounds Area 4 YES/NO (please confer with Clutha Rugby club) Football Ground No 2 Area 5 YES/NO (please confer with the Football Club) ALTERNATIVE DAY IF CANCELLED: . All representative/tournament games to be booked separately to seasonal bookings on a separate form. Days required in addition to regular fixtures must be applied for separately. Grounds and Buildings are to be left in their original condition at time of hire and any expenses incurred by the Clutha District Council in rectifying damage will be on charged to the hirer. The removal of rubbish will be the responsibility of the hirer. The cost of removal of rubbish left behind will be charged back to the hirer. Council/contractor reserves the right to cancel the use of any sports ground during periods of inclement weather or maintenance activities. Council would like to remind all sport clubs that line spraying with Round Up or an equivalent herbicide is only permitted at the start of each season. Additional marking solution will need to be approved by Council. The hirers consider their own health and safety requirements and if requested provide a copy of documentation to Council. Seasonal Casual Signature: Date: For any queries concerning ground hire, please contact: SouthRoads Ltd, Balclutha, Ph 03 418 4510 during working hours. Hiring of Administration Block and Stock Pavilions – please refer to The Secretary, South Otago A & P Society, P O Box 226, Balclutha. Phone (03) 4181693. FIRE SAFETY REQUIREMENTS It is important that in using these facilities you do not carry out alterations or decorate a building in such a way or with materials which might increase the risk of spread of fire or impede evacuation of the building in the event of fire. Before carrying out any work of this nature, please ensure you consult a Fire Safety Officer from the Dunedin office of the Fire Service (Ph. 03 474 0709), or a Council Building Officer (Ph. 03 419 0200). Clutha District Council, 1 Rosebank Terrace, PO Box 25, Balclutha 9240 P: 03 419 0200; F: 03 418 3185; E: [email protected] www.cluthadc.govt.nz Form Updated June 2017 1 2 CORONATION PARK & 2 RIVERSIDE RESERVE Area 2 LOCATION MAP 6 Area 1 5 4 2 2 3 6 Area 3 9 Area 4 ± 30 15 0 30 60 90 120 Metres 7 Area 5 1. Clutha Rugby Football/Squash Clubs 2. South Otago A&P Society Buildings 3. Grandstand & Public Toilets 4. South Otago Football Assoc Pavilion 10 5. South Otago A&P Society Stables 6. South Otago A&P Society Stock Pens 7. Cross Recreation Centre 8. Car Park 8 9. Cricket Pitch 10. Riverside Reserve Toilet Block Produced by Clutha Dis trict Council’s GIS Section. coronation_park.mxd.