• Location selection

  • Your information

  • Host information

    A host is a person facilitating the activity, please enter the primary facilitator in the field below and any other facilitators in the fields that follow. The primary host must have a current Working With Children's Check (WWCC) or VIT Registration.
  • About your proposed activity

  • Please provide the name of your activity/experience and a brief description.
  • This is only applicable if your activity/experience links to the EYLF.
  • Please provide a brief description of any equipment or other information relevant to your planned activity/experience e.g. gazebo, tables and how much space you need.
  • Drop files here or
    Accepted file types: jpg, gif, png, pdf, eps.
    Please attach a copy of your Public Liability Insurance as this event is taking place in a public location.
  • Show Bags

    Do you have any material you would like to include in the event show bag? This is a great way to promote your services, so we encourage you to participate. For those of you who do have suitable promotional material, please select from the options below. If you select 'other' add a brief description to the Additional Comments field at the end of this form. We require 200 units of each promotional item (per event) to ensure your organisation is represented in each show bag. Please post your promotional material to Cire Services Inc. Yarra Junction picnic - 2463 Warburton Hwy, Yarra Junction 3797 or drop by in person. We're easy to find, right next door to the Yarra Junction Post Office. Chirnside Park picnic - 33 Kimberley Dr, Chirnside Park, or drop by in person (5 minutes from the shopping centre). All promotional material is required before by Friday 11th October 2019.
    I/we agree to and provide permission for Cire Services Inc. and Yarra Ranges Council to use my/our photograph in Cire Services Inc and Yarra Ranges Council publications and digital media. If any of your hosts do not wish to be photographed, please have them call Melissa Lizza 1300 835 235 or email melissalizza@cire.org.au.