Submitting this form does not guarantee access to a seasonal ground allocation but will provide vital information for future developments or proposed sporting reserves and facilities.
This information will be kept on file, and should suitable sporting reserves and facilities become available, clubs will be notified and invited to apply for a seasonal ground allocation.
Please assist the City of Casey by providing the information requested below as accurately as possible.
Contact Information
Organisation:
Postal Address:
Postcode:
Contact Name:
Position:
Phone (BH): / Mobile:
Email:
Website:
Club Information
Sport (ie soccer, AFL):
What age groups does your club/organisation offer? / Junior Senior
Is the club/organisation incorporated? / Yes No g
If yes, what is your incorporation number?
Does your club have public liability insurance? / Yes No g
If yes, who is your insurer?
What is your policy number?
Membership
Total number of teams:
Total number of current members:
Percentage of players who live within the City of Casey:
Is your club currently associated with a State Sporting Association?
(ie. Football Federation Victoria, AFL Victoria, Cricket Victoria, etc) / Yes No g
What league does your club currently participate in?
At which reserve/location does your club currently participate in sport? (Please include any reserve outside the City of Casey.)
Has your club previously been allocated or played at any Council reserves in the City of Casey? / Yes No g
If yes, which reserve?
What are your clubs’ facility requirements?
(ie. 1 junior oval with pavilion)
Is there any other information you would like to provide?
Privacy Statement
Personal Information collected by the City of Casey is used for municipal purposes as specified in the Local Government Act 1989. The Personal Information will be used solely by the City of Casey for these purposes or directly related purposes. The City of Casey may disclose this information to other organisations if required by law/legislation or consent is given. The applicant may apply for access and/or amendment to the Personal Information. Request can be made to Council’s Privacy Officer.
As a delegate of the organisation listed above, I acknowledge that this expression of interest is not a guarantee access to a seasonal ground allocation and that confirm that the information provided is true and correct at the time of submission.
Name: / Position:
Signed: / Date:
Please return this form to:City of Casey
Leisure Development Team
PO Box 1000
Narre Warren VIC 3805
Or email to: