ANNUAL REGISTRATION OF A CLUB/GROUP OR SOCIETY FOR 2016

Transcription

1 ANNUAL REGISTRATION OF A CLUB/GROUP OR SOCIETY FOR Name of club/group or society Official name Abbreviation 2. Public contact details Please note the details you provide here will be publicly available through the VUW website Online Clubs Directory Name of main contact Telephone Postal address / PO Box Principal Location Brief purpose and description of activities Other contact Website Address Other Locations If your club would like to include a photograph and blurb with your Victoria University online Clubs Directory listing, please details to victoriaclubs@vuw.ac.nz 3. Legal and Financial Structure The society s legal status is: e.g. Unincorporated group, Incorporated Society, Charitable Trust Is your organisation affiliated to a regional or national association? If yes, please attach verification of this Yes Affiliated No to: Annual General Meeting (AGM) will usually be held in the month of: Please attach a copy of Updated: Club constitution or rules signed by the President/Chairman Already submitted Minutes of the most recent AGM Financial Statements (Profit & Loss Report, Balance Sheet, and Treasurer s Report as approved at most recent AGM) 5. Membership profile & fee subscriptions Please attach a list of student members including Student IDs (no face-book pages) Number of current student members Number of Alumni members Number of public members Total Membership of club Cost of student subscription Cost of Alumni subscription Cost of public member subscription If do not charge subscriptions, please explain why? VICTORIA UNIVERSITY OF WELLINGTON VICTORIA CLUBS REGISTRATION PACK REGISTRATIONS DUE 1 APRIL 2016 PAGE 1

2 Funding application planning Please tick one We do not expect to apply for funding this year We plan to submit a funding application to the funding round held in (month) Project name and start date High Performance Sport Recognition & Club Executive Recognition How does your club identify and encourage high performance members to be recognised? e.g. through active promotion, tracking and nominations to University Blue Awards, Victoria Plus, or Individual student sponsorship. Sports clubs only How many University Blue Award nominations will come from your membership for 2016? (estimate) 7. Contacts for committee The contacts you provide here will not be publicly available. All details are required President/Chairman name Student ID Home phone Mobile Secretary name Student ID Home phone Mobile Treasurer name Student ID Home phone Mobile Victoria Clubs Representative name Student ID Home phone Mobile Other committee members Name Student ID (if applicable) 8. Insurance Please fill in the attached form for student clubs to be covered under the VUW Insurance Policy; VICTORIA UNIVERSITY OF WELLINGTON VICTORIA CLUBS REGISTRATION PACK REGISTRATIONS DUE 1 APRIL 2016 PAGE 2

3 All clubs to fill in the attached questionnaire We do not require club insurance Registered Victoria University clubs are covered under the University s General Liability and Professional Indemnity insurance policies. Clubs which use University/VUWSA vehicles will also be covered under the University s Motor Vehicle Policy, providing drivers are driving within the terms of their licence. The General Liability policy covers clubs legal liability arising from third party personal injury or property damage, and has an excess of $1000. The Professional Indemnity policy covers claims arising from any breach of professional duty in the course of a club s activities (for example, the giving of professional advice, or unintentional defamation), and has an excess of $20,000. Clubs are not covered under the University s management liability policies (such as the Directors and Officers policy), which would cover club directors/executive members in the event of a claim against them for a wrongful act in the discharge of their duties. Loss or damage to club property is also not covered. If you believe your club requires these types of cover, or have any other queries about the level of insurance your club has, please insurance-help@vuw.ac.nz. Please note that your club s insurance cover is conditional upon proper information being provided on your insurance declaration and throughout the year as required. To ensure you have appropriate cover, be sure to notify us throughout the year if you club is, for example; Organising off-campus or overseas events Balls, Seminars etc; Entering into any contracts Venue Hire, Security; Hiring equipment; Giving professional advice; or Undertaking any other high-risk activities. VUW Clubs Insurance Liability Form 2016 VICTORIA UNIVERSITY OF WELLINGTON VICTORIA CLUBS REGISTRATION PACK REGISTRATIONS DUE 1 APRIL 2016 PAGE 3

4 1.1 Club General Activities 2.1 Do you carry out activities away from your premises? Club Sport/Social/Rep Description of Activities Membership 2.2 Do any of your activities involve cutting or welding, the use of naked flames or open heat sources? 2.3 Do you use, store, handle, manufacture or transport any acids, bulk liquids, chemicals, explosives, gases or any flammable, hazardous or toxic goods or services? 2.4 Do you own, possess or use watercraft or aircraft? 2.5 Do you service, repair, work on or supply parts for third party property, including motor vehicles, watercraft or aircraft? 2.6 Do you have property owned by others in your care, custody or control? VICTORIA UNIVERSITY OF WELLINGTON VICTORIA CLUBS REGISTRATION PACK REGISTRATIONS DUE 1 APRIL 2016 PAGE 4

5 2.7 Do you charge a fee for storing property owned by others? Commercial Activities and Consultation Work 3.1 Do you manufacture, sell or supply any goods or products? 3.2 Do you design parts or completed components for others? 3.3 Have you or do you undertake or provide contract research, external consulting or other professional undertaking for third parties? 3.4 Have you ever undertaken or are likely to undertake activities overseas? Contractual Obligations 4.1 Have you, do you, or are you likely to enter into contracts for the provision of services by you for third parties? VICTORIA UNIVERSITY OF WELLINGTON VICTORIA CLUBS REGISTRATION PACK REGISTRATIONS DUE 1 APRIL 2016 PAGE 5

6 4.2 Have you, do you, or are you likely to enter into contracts engaging consultants, contractors, sub-consultants or sub-contractors to provide services for you? Claims and Insurance History 5.1 After enquiry, has there been or is there now pending any claim against any director, officer, senior employee or trustee or member of the Club in their capacity as a director, officer, senior employee or trustee (as applicable) or any other company or entity in which they are or have been involved, or are they aware of any pending or prior claim against any person proposed for cover? 5.2 After enquiry, is there now pending or has there ever been any prosecution of the Club: under the Fair Trading Act, Companies Act, Health & Safety in Employment Act or any other legislation? 5.3 After enquiry, is there now pending any claim or litigation against or involving the Club? 5.4 After enquiry is there any official or regulatory investigation, examination or inquiry pending or current, or has there been any official or regulatory investigation, examination or inquiry commenced involving the Club or its members? VICTORIA UNIVERSITY OF WELLINGTON VICTORIA CLUBS REGISTRATION PACK REGISTRATIONS DUE 1 APRIL 2016 PAGE 6

7 8. Declaration I declare that; this Registration application and Insurance for club/society is on behalf of the club committee to the best of my knowledge the information provided in this application is true and correct we understand that our club must operate under our constitution, and at the same time abiding by any Victoria University of Wellington statutes, policy and rules in place. MUST BE SIGNED BY PRESIDENT/CHAIRMAN OF THE CLUB/SOCIETY Full Name Position Signature Date COUNTER SIGN BY ANOTHER MEMBER OF YOUR EXECUTIVE COMMITTEE Full Name Position Signature Date Please return form to: Clubs Manager, Victoria University of Wellington Level 3, 6 Waiteata Road Kelburn PO Box 600, Wellington For assistance telephone or victoriaclubs@vuw.ac.nz 9. Privacy Statement This Registration form collects information about your club and its committee members. The information is collected to evaluate your club s registration with the University and for planning related to the development, funding and insurance of clubs activities. The intended recipients of the information are the VUW Recreation Services club support staff, the VUW Sponsorship Committee, the VUWSA Clubs Council and the University s insurer. The information is held by the Clubs Manager. The Clubs Manager will make information held about students available to them upon request and in accordance with the Privacy Act Current Club Committee members have rights of access to and correction of club information. Named club committee members have the right to access and request correction of their personal information. REGISTRATIONS ARE DUE BY: 1 APRIL 2016 Application Receipt Name of Club Date Received by Clubs Manager Registration form Insurance form VICTORIA UNIVERSITY OF WELLINGTON VICTORIA CLUBS REGISTRATION PACK REGISTRATIONS DUE 1 APRIL 2016 PAGE 7

8 2016 Student Club Membership Name - First Name - Surname Student Number Eg Mary Smith VICTORIA UNIVERSITY OF WELLINGTON VICTORIA CLUBS REGISTRATION PACK REGISTRATIONS DUE 1 APRIL 2016 PAGE 8