Hay Shire Council Event Application
EVENT DETAILS
NAME OF EVENT
*
DATE OF EVENT
*
-
Day
-
Month
Year
Date
LOCATION OF EVENT
*
SET UP DATE (When will you require this location prior this event)
*
-
Day
-
Month
Year
Date
Time
Hour Minutes
AM
PM
AM/PM Option
PACK DOWN DATE (When will you require this location post this event)
*
-
Day
-
Month
Year
Date
Time
Hour Minutes
AM
PM
AM/PM Option
TYPE OF EVENT
*
COMMUNITY EVENT
TICKETED
MARKETS
SPORTING
OTHER (please state)
PLEASE DESCRIBE YOUR EVENT IN DETAIL (eg community fundraiser including markets and entertainment)
*
NAME OF ORGANISATION HOLDING THE EVENT
*
CONTACT PERSON FOR THIS EVENT
*
CONTACT PERSON PHONE NUMBER
*
CONTACT PERSON EMAIL
*
HAVE YOU RECEIVED SPONSORSHIP FROM HAY SHIRE COUNCIL FOR THIS EVENT?
*
YES
NO
IF YES, HOW MUCH SPONSORSHIP HAVE YOU RECEIVED FROM HAY SHIRE COUNCIL FOR THIS EVENT?
REQUEST FOR EQUIPMENT AND SERVICES
REQUEST FOR COUNCIL SERVICES
*
DELIVERY AND COLLECTION OF EXTRA RUBBISH BINS
DELIVERY OF LARGE SCALE WASTE
EVENT PROMOTION
N/A
REQUEST FOR COUNCIL EQUIPMENT (Pick up and return of Council equipment is the responsability of the event organiser. Delivery/return by Council staff may incur an additional fee)
*
PARTY TRAILER (180chairs and 30 tables) - FEES $200 to hire $250 bond for community groups, $500 bond for private use.
MARQUEE (3 available) - FEES applicable.
BOLLARDS AND FLAGS FOR CROWD CONTROL
PA SYSTEM
N/A
BANK DETAILS: Please add your bank details below for return of bond money where applicable.
ROAD CLOSURE
WOULD YOU LIKE TO REQUEST A ROAD CLOSURE OF LOCAL OR STATE ROADS FOR YOUR EVENT? (please note, if you require a closure of a road, a written request to council must be submitted 3 months prior to your event. There may be fees associated with road closures, these may be charged to the event organiser. Council may not have the resources to implement the road closure even if it has been approved.)
*
YES
NO
PLEASE UPLOAD A LETTER OF REQUEST FOR THE ROAD CLOSURE.
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SITE MAP
HAVE YOU PROVIDED A DETAILED SITE PLAN/MAP? (plan/map should include parking, toilets, food & drinks, entertainment, fencing, emergency access and first aid.)
*
YES
NO
PLEASE UPLOAD A DETAILED SITE PLAN/MAP
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PLEASE PROVIDE DETAILS OF ANY TEMPORARY STRUCTURES THAT MAY BE USED AT YOUR EVENT (eg yards, fencing, tents, marquees)
INSURANCE
DO YOU HAVE PUBLIC LIABILITY INSURANCE OF $20MILLION TO COVER YOUR EVENT?
*
YES
NO
PLEASE UPLOAD A COPY OF YOU PUBLIC LIABILITY INSURANCE COVER FOR YOUR EVENT OF $20 MILLION. (This is a requirement to hold an event on or in council land/buildings. Please forward your Certificate of Currency with this application)
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WILL YOUR EVENT HAVE MARKET STALLS?
YES
NO
IF YES TO MARKET STALLS, DOES YOUR ORGANISATION'S PUBLIC LIABILITY INSURANCE FOR THIS EVENT COVER THESE STALLS?
YES
NO
IF YOUR PUBLIC LIABILITY DOES NOT COVER MARKET STALLS, HAVE YOU SITED EACH MARKET STALLS CERTIFICATE OF CURRENCY?
YES
NO
FOOD & BEVERAGES
WILL FOOD AND BEVERAGES BE AVAILABLE AT YOUR EVENT?
*
YES
NO
WILL FOOD AND BEVERAGES BE SOLD AT YOUR EVENT?
*
YES
NO
IF YES TO ABOVE QUESTION, PLEASE COMPLETE BELOW
Rows
YES
NO
ARE FOOD VENDORS REGISTERED WITH NSW FOOD AUTHORITY?
DO ALL FOOD VENDORS HAVE PUBLIC LIABILITY?
DO ALL FOOD VENDORS HAVE FOOD SAFETY SUPERVISOR ON SITE?
IS ALCOHOL PERMITTED AT YOUR EVENT?
*
YES
NO
IF YES TO ALCOHOL, HOW WILL IT BE SUPPLIED?
*
BYO
SOLD AND/OR SUPPLIED
N/A
IF SELLING ALCOHOL, DO YOU HAVE AN APPROPRIATE LICENCE APPROVED BY THE OFFICE OF LIQUOR, GAMING AND RACING (www.olgr.nsw.gov.au this is a requirement to hold an event on or in council land/building)
YES
NO
PLEASE UPLOAD YOUR LIQUOR LICENCE (IF YOUR ORGANISATION IS RUNNING THE BAR.)
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AMUSEMENTS
INFLATABLE AMUSEMENTS REQUIRE ADDITIONAL INFORMATION. PLEASE PROVIDE DETAILS AS REQUIRED.
WILL THERE BE INFLATABLE AMUSEMENTS AT YOUR EVENT?
*
YES
NO
IF YES, PLEASE PROVIDE THEIR CONTACT INFORMATION, FOR COUNCIL REPRESENTATIVE TO DISCUSS ADDITIONAL REQUIREMENTS.
FULL NAME
EMAIL & CONTACT NUMBER
FIREWORKS
WILL THERE BE FIREWORKS PRESENT AT YOUR EVENT?
*
YES
NO
IF YES, PLEASE PROVIDE THE CONTACT INFORMATION FOR THE BUSINESS ENGAGED TO FIRE THE FIREWORKS. A COUNCIL REPRESENTATIVE WILL CONTACT THEM TO DISCUSS ADDITIONAL REQUIREMENTS. (Once all documentation has been supplied to council by your contractor, an approval to fire letter will be issued. This will be separate to your approval letter. Fireworks display cannot occur until you have received this approval to fire letter).
FULL NAME
EMAIL & CONTACT NUMBER
RISK & EMERGENCY SERVICES
HAVE YOU COMPLETED A RISK ASSESSMENT FOR THIS EVENT? (Risk Assessment is a requirement to hold an event on or in council land/buildings.)
*
YES
NO
PLEASE UPLOAD RISK ASSESSMENT HERE
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HAVE YOU NOTIFIED THE FOLLOWING EMERGENCY SERVICES ABOUT YOUR EVENT?
*
Rows
YES
NO
POLICE
AMBULANCE
RURAL FIRE SERVICE
TERMS & CONDITIONS
I UNDERSTAND THAT THIS IS ONLY AN APPLICATION FOR THE EVENT AND I WILL RECEIVE A CONFIRMATION LETTER FROM COUNCIL ONCE THIS APPLICATION IS APPROVED.
*
YES
NO
CHECKLIST (Please tick where applicable)
PUBLIC LIABILITY (CERTIFICATE OF CURRENCY) ATTACHED - REQUIRED
RISK ASSESSMENT ATTACHED - REQUIRED
SITE PLAN/MAP - REQUIRED
ROAD CLOSURE REQUEST
LIQUOR LICENCE - ONLY IF YOUR ORGANISATION HOLDS THE LICENCE.
NAME OF APPLICANT
*
FULL NAME
DATE
SIGNED
*
SUBMIT
SUBMIT
Should be Empty: