Booking Form - ACT Museums and Galleries

CANBERRA MUSEUM + GALLERYCnr London Cct & Civic Square Canberra | museumsandgalleries.act.gov.au | PO Box 939 Civic Square ACT 2608CMAG VENUE HIREBOOKING FORMt +61 2 6207 2662 | f +61 2 6205 8083 | e cmag.venuehire@act.gov.au | w museumsandgalleries.act.gov.auVenue Hire office hours Tuesdays & Thursdays 10am - 5pm, except by appointment.Please ensure you have made a tentative booking before submitting this form.Contact the Venue Hire Coordinator (as per the details above) to check availability and place a tentative booking.For details on pricing, equipment and catering, please see the CMAG Venue Hire information sheet.BOOKING CONTACT DETAILSOrganisation:Postal address:Contact name:Phone:Fax:State: Postcode: Email address:Not-for-profit/Community Group Commercial/Government CMAG Corporate MemberVENUE DETAILSFOYER BOARDROOM PUBLIC MEETING ROOM THEATRETTEDate of booking:Arrival time (incl. set up): Departure time (incl. pack down): Total hours:Function start time:Function end time:Name of host/facilitator of function:Phone (on date of booking):EVENT DETAILSFunction title:Number of attendees:Description of booking:Is this event open to the Public? YES NOIf YES, CMAG may be able to promote your event. Please enquire for details.

CATERING DETAILSWill the event be catered? YES, (self-catered) YES (external caterer) NOIf YES (external caterer), Please provide name of caterer:IN-HOUSE CATERING & OPTIONAL EXTRASCoffee service/catering - price includes setup (indicate quantity)Optional equipment (indicate if required)Item price qtyCrockery – dinner plate $0.90Crockery – side plate $0.90Glasses – wine $0.90Glasses – champagne $0.90Glasses – tumbler $0.90White damask tablecloths (dry clean, per table) $38.00Plastic tablecloth (per table) $8.00Tea/coffee (per head) $3.00Tea/coffee/biscuits (per head) $4.50Full day tea/coffee (three serves per head) $7.00Full day tea/coffee/biscuits (three serves per head) $9.00Item price req’dElectronic whiteboard $40Laptop computer $60Projector + screen, portable$80(price applicable to foyer only)Stage (available in foyer only) $120Flip chart (includes easel, pens & paper) $35Fender portable PA systemfree(available in foyer only)Trestle table (6 available, indicate quantity) freeCMAG also has an in-house cafe, we are able to set up a tab and pre-order food if desired. Please request a CMAG Cafe tab form if you areinterested.DECLARATIONI have attached the following:• A valid certificate of currency of Public Liability Insurance, minimum value of AUD$10 000 000(Government agencies excluded)• Documentation verifying your organisation’s not-for-profit status (if applicable)By signing below, you confirm that you have read, understood and agree to the CMAG Venue Hire terms &conditions of hire provided to you at the time of tentative booking.Clients’ signatureSigned by (print full name)For and on behalf of organisation/companyDate