Event Cover - Enquiry Form

Event Cover - Enquiry Form

In order for us to fully consider your request for First Aid cover at your event please complete this form with as much information as possible. Please contact 016688077 or eventcover@stjohn.ie with any questions you may have
Organisation / Company Name:*
Main Contact Name:*
Address (Of Organisation/Organiser)*

Street Address

Street Address Line 2

CityCounty

Eircode
Landline/Main Phone Number:*

Area CodePhone Number
Mobile/Direct Phone Number:*

Area CodePhone Number
Contact Email
example@example.com
Event Details:
Event Name *
Event Location and Eircode*
Event Cover Start Date and Report Time:*

DayMonthYear
Event Cover to Start:HourMinutes
Event Cover End Date and Stand down Time:*

DayMonthYear
Event Cover to Finish:HourMinutes
For Multiple Days, or Multiple Events, please specify required dates and times here:
If the event specifics are different for other dates, please fill in a new form per event
Please describe event in full and outline all activities that will be taking place: *
Event Website (Or Online Location for Further Information):*

How will they be accommodated? (Select all that apply)*

StandingSeatedOther
Will refreshments be provided for staff?*
Are parking facilities available for staff? *
Are there any other organisations involved in medical provision or assisting in other ways? Please outline fully (if applicable)
Risk Assessment
Is there a facility available for treating casualties in private?*
We can provide these facilities if needed
Please detail the cover you feel is required for your event, *
e.g. Number of Ambulances, First Aid Points, Response Vehicles, Buggy, Paramedics, Emergency Medical Technicians, First Aid Responders. Estimate how many. (Details of what your last Medical Team supplied would be a good starting point).
Does your risk assessment highlight any specifics we need to know about before the day? *
Examples could be hazards, capacity etc. please outline all known risks.
Does your event comply with current government guidelines in relation to COVID - 19 *
You will need to provide us with a copy of your event management plan along with your covid-19 policy and procedures
Please detail any further supporting information:
Upload any Supporting Documentation:

Browse Files
e.g. Risk Assessments, Maps, Event Specifications etc. Cancelof
By submitting this form, I understand that I am requesting a quotation for the services of St John Ambulance Ireland. I acknowledge that completion of this form does not constitute a firm booking. I have completed this form with the correct information to the best of my knowledge and will undertake to inform SJAI of any changes to the information. I will forward all relevant documentation to SJAI, including risk assessments, site plans and emergency escalation plans.*

I AgreeOther
Thank you for taking the time to complete this form. We will review the information provided and will contact you within 3 business days
Should be Empty:

	Total Max Overall	Max at any One Time
Participants
Spectators
Staff/Volunteers

Event Cover - Enquiry Form

Event Details:

Risk Assessment