NCA - PERMIT APPLICATION FORM

Event Details
Event Name*
Event Organiser*
Note: the Event Organiser is the person or organisation whose name the Public Liability Insurance is taken out for the event (not required for weddings)
Event Type*
Location*
Event Date*

DayMonthYear
Shortest lead time = 14 days, please call (02) 6271 2888 for urgent inquiries
Event Start/Finish Time*

Event Starts

To
until
Event Ends
Bump In/Out Time

Bump In Starts

To
until
Bump Out Ends
Estimated Attendance*
Spectators/Participants

Event Overview
Event proposal and executive summary*
Please include an accompanying site plan and any other documentation to support your application

Cancelof
To hold my event, I

Will have Infrastructure (such as Marquee, food trucks, signs/A frames - works approval required and fees apply)Need to close a road or lakeRequire vehicles access to site (works approval required and fees apply)Require powerIntend to hire the Kiosk (OPH Garden Bookings Only)

Indemnity
In consideration of the Commonwealth of Australia (hereinafter called 'the Commonwealth') permitting the use of National Land
I/We*
hereby indemnify and will keep indemnified the Commonwealth, its officers, employees and agents from and against all actions, claims, demands, costs and expenses (including the cost of defending or settling any action, claim or demand) made, sustained, brought or prosecuted in any manner based upon, occasioned by or attributable to any injury, to any person (including death) or loss of or damage to property which may arise from or be a consequence of any unlawful or negligent act or omission of the person or organisation, its officers, employees or agents in carrying out the activity.
Signed*

Clear
Date*

DayMonthYear
eventType
Should be Empty:

EVENT PERMIT APPLICATION FORM