School Picnics on Council Land Application Form

Event Details

Event name(Required)

Event location(Required)

Street Address Suburb Post Code

Describe the event program and objectives(Required)

Event date(Required)

Event start time(Required)

Event finish time(Required)

Expected attendance numbers

If your expected attendance is greater than 1,000 persons for more than two hours, you are required to lodge a place of assembly licence – located at www.ccc.tas.gov.au

Total number of persons expected(Required)

Event Applicant Details

School name(Required)

Event Organiser

Name(Required)

First name Surname

Position(Required)

Phone(Required)

Email(Required)

Address(Required)

Street Address Suburb Post Code

Onsite Emergency

Name(Required)

First name Surname

Phone(Required)

Site Infrastructure

As of 21 December 2021 inflatable devices (jumping castles, inflatable slides, zorb balls, etc) will not be permitted on council land until further notice.

Marquees(Required)

Yes

If yes, number of marquees:

If yes, size of marquees

Other structures e.g. large umbrellas(Required)

Yes

If yes, provide details of other structures including the number of and size:

Waste Management

Council requests that you take away any rubbish generated by your school group and leave the area clean and tidy.

Will the council toilets on site by utilised?(Required)

Yes

Will the council bins on site be utilised?(Required)

Yes

Food Management

Will food be sold at the event?(Required)

Yes

E.g Food or coffee vans.

Social Inclusion and Accessibility

For guidance, see our Planning a Better Event Toolkit at www.ccc.tas.gov.au

Does the event promote social inclusion and provide accessibility solutions for people with disabilities?(Required)

Yes

If yes, provide details:

Insurance and Risk Management

The following must be included with your application form – Download the City of Clarence Event Risk Assesment Guide and template.

Risk assessment(Required)

Drop files here or

Accepted file types: xls, xlsx, jpg, gif, jpeg, png, ico, pdf, doc, docx, ppt, pptx, pps, ppsx, odt, Max. file size: 20 MB.

You may be required to make a presentation to Council depending on the nature of your event and the associated risks. You will be advised accordingly.

Copy of your public liability insurance to the value of $20,000,000 current as of the event date.(Required)

Accepted file types: xls, xlsx, jpg, gif, jpeg, png, ico, pdf, doc, docx, ppt, pptx, pps, ppsx, odt, Max. file size: 20 MB.

Site Plan

Upload your site plan below. Site plan to include: – Placement of all existing and temporary equipment proposed to be set up; – Naming of included roads; – All temporary structures (tents, marquees, toilets, bins, fencing, stages, signage); and – Location of bus parking (if applicable).

Upload site plan(Required)

Drop files here or

Accepted file types: xls, xlsx, jpg, gif, jpeg, png, ico, pdf, doc, docx, ppt, pptx, pps, ppsx, odt, Max. file size: 20 MB.

Terms and conditions

Terms & Conditions for permits & licences issued by council for events under council’s Public Places By-law 2018: • The permit is not assignable or transferable. • The permit holder must comply with all requirements, notices and directions given to the permit holder by council or any public or statutory authority and must comply with all acts, regulations, by-laws, codes and all Australian standards applicable to the land or premises which are the subject of the permit. • The permit may be cancelled by council if the permit holder fails to observe or comply with the terms and conditions of the permit. • The permit holder agrees to indemnify, and keep indemnified, and to hold harmless council, its servants and agents, and each of them from and against all actions, costs, claims, charges, expenses and damages whatsoever which may be brought or made or claimed against them arising out of, or in relation to the permit. • If the event is on council land, the permit holder is to have, during the term of the permit, a public liability insurance policy in a form approved by council, of a sum not less than twenty million dollars ($20M or more) in respect of the land or premises.

Personal Information Statement

City of Clarence will only use the personal information on this form for facilities management and related purposes. If this information is not provided, we may not be able to deal with this matter. You may access and/or amend your personal information at any time. How we use this information is explained in our Privacy Policy.

Authorisation(Required)

I have completed this event notification form to the best of my knowledge and agree to adhere to all the reasonable requests made during the assessment and planning phase that may be stipulated by Clarence City Council and other agencies. I acknowledge and accept the terms and conditions of any permits and licenses that may be issued under council’s Public Places By-Law 2018.

I agree that by typing my name below, I have signed this form.

Event organiser name(Required)

A council officer may contact you to verify your identity.

Date(Required)

Comments

This field is for validation purposes and should be left unchanged.

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School Picnics on Council Land Application Form