To start the process, turn the page and complete the Event Application Form.

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Pyrenees Shire Council asks all organisers planning an event within Shire boundaries to submit this form to ensure they comply with legislative requirements. For more detailed information about why events must comply, please refer to EVENTsense, the event organiser s guide. EVENTsense goes into much more detail about what you need to do when organising an event and we encourage you to read it before starting any paperwork. You can also contact the Events Officer: P: (03) 5349 1153 M: 0439 073 547 E: events@pyrenees.vic.gov.au Pyrenees Shire Council recommends you leave as much time as possible before your event to plan and lodge this form. This is because the documents you may require can take a while to process. We recommend you submit the Event Application Form at least six months before a small event and at least 12 months before a large event. The steps in the event approval process are outlined below but it is important to note the time frames will vary for different events, depending on their size and complexity. Approvals and permits may be needed from other authorities aside from Council, so it s important to take those into consideration. As an event organiser, it is your responsibility to ensure all information is provided and the relevant approvals are obtained before holding your event. Complete this form, develop a site plan, attach the relevant documents (see page 8) and post or email them to: The Events Officer Pyrenees Shire Council Post: 5 Lawrence Street BEAUFORT VIC 3373 Fax: (03) 5349 2068 Email: pyrenees@pyrenees.vic.gov.au The Events Officer discusses your event with the relevant Council officers, assesses it ascertains the permits and permissions your event requires. The Events Officer then contacts you regarding these permits and how to apply for them. The event organiser applies to the Council and other authorities for the relevant permits and permissions. The Council processes the documents and if necessary, requests further information before issuing the necessary permits and permissions to the event organiser. The Events Officer, together with the event organiser, confirms all permits, permissions and documents are in place and the organiser goes on to hold a safe, successful and well-attended event! To start the process, turn the page and complete the Event Application Form. Page 2 Current November 2013

PLEASE NOTE sections marked with an asterisk * will be used in our events calendars and printed material, which are publicly available. Do not include details you do not wish to be made public. Please submit on CD or via email an electronic copy of at least one high-resolution (1MB, 200DPI) image to be used for publicity purposes. EVENT DETAILS * Event name: * Event date/s: * Day 1 Start time: Finish time: * Day 2 Start time: Finish time: * Day 3 Start time: Finish time: * Day 4 Start time: Finish time: * Event location/s and address: Include VicRoads country map reference if relevant. * Event website and email address: Include an event email and a website or Facebook page address if you have one. * Event contact person and phone number: Provide a name and phone number the public can use. * Event description: Provide a brief description of around 200 words that can be used to market and promote your event. Page 3 Current November 2013

YOUR EVENT S SPECIFICS Do you require a Council official (Mayor, Councillor/s, CEO) to perform official duties at your event? If yes, detail whom, when you require them (date, time), and details of where they need to be and what you wish them to do: Will your event have marquees, tents or booths with a floor area more than 100m 2? Will your event have seating stands for more than 20 people? Will your event have stages or platforms (including sky boarders and stage wings) exceeding 150m 2 in floor area? Will your event have any prefabricated buildings exceeding 100m 2 other than ones placed directly on the ground? Will your event have a first-aid room? Applicable only if patron numbers are expected to be over 5,000. Will your event disrupt traffic or need road / street closures? Will your event require speed reductions on nearby roads for safety reasons? Will your event include alcohol? Will your event include food? Will your event include fireworks, pyrotechnics and/or fire? Will your event need promotional signage outside the event site? Will your event generate rubbish? Will your event include camping? Will your event be held on private property? Will your event include the sale of any items? Page 4 Current November 2013

Please list any other activities or entertainment at the event: ie/ market stalls, children s activities, amusement rides, jumping castle, live music, cooking demonstrations etc. Have you contacted any other authorities regarding this event? Please tick: Victoria Police Ambulance Victoria Country Fire Authority SITE PLAN I have attached a detailed plan or map of the preliminary layout of the event site, including the location of toilets, water, first aid posts, emergency entry/egress and emergency evacuation areas. Refer to EVENTsense for more information on site plans. Yes PUBLIC LIABILITY INSURANCE All events held in Pyrenees Shire must have public liability insurance of either $10 million or $20 million. Please fill in the details below and attach your certificate of currency. Name of insurer: Public liability value: Expiry date: I have attached a copy of our certificate of currency. Yes Page 5 Current November 2013

EVENT ORGANISER DETAILS PLEASE NOTE sections marked with an asterisk * will be used in our events calendars and printed material, which are publicly available. Do not include details you do not wish to be made public. * Organisation name: Status of organisation: ie/ incorporated association, company, community group Is your organisation a not-for-profit group? Yes No CONTACT DETAILS Key contact person * Name: * Position: Phone: * Mobile * Home * Work Address: * Email: Secondary contact person * Name: * Position: Phone: * Mobile * Home * Work Address: * Email: Page 6 Current November 2013

TO BE SIGNED BY THE EVENT ORGANISER I, acknowledge that we are required to supply all information and follow all processes as per EVENTsense, the Pyrenees event organisers guide, and the instructions provided by the Events Officer. Signed: Date: Print name: ACKNOWLEDGEMENT AND AUTHORISATION Please sign this acknowledgement / authorisation to give Council permission to include your event and organisers details on websites, on Facebook pages and in printed and other material. I, am authorised to lodge this application seeking approval to host an event within the Pyrenees Shire. I acknowledge that the information contained in this form is true and correct. I understand that the information contained in this form is being collected by Pyrenees Shire Council for inclusion on Council websites and Facebook pages, and in printed publications and other material. This information will be subject to the Council s Privacy Policy and will be used solely by the Council for the purposes of promoting this event. I understand I may apply to the Council to amend and update this information. Signature: Date: Position: Please note Pyrenees Shire Council will make every effort to avoid errors in event listings. The Council reserves the right to either reject or remove any listings. The Pyrenees Shire Council is not liable for any loss or damage incurred by the event organiser as a result of any listings. Updates are not possible on printed material, however will be made to website listings. Page 7 Current November 2013

Before you lodge this form, have you Please select Filled in all sections of the event application form? Signed where marked? Attached your insurance certificate of currency? Attached your risk assessment and management plan? Attached your emergency management plan? Attached a detailed site plan? Attached as a separate electronic.jpg file on CD or via email at least one high-resolution photo to help promote your event? Please note the requirements listed in this table are explained in more detail in EVENTsense, the event organiser s handbook. Please refer to EVENTsense for more information. Once you have completed and signed all sections of this form, please forward it and any relevant documents to: The Events Officer Pyrenees Shire Council 5 Lawrence Street BEAUFORT VIC 3373 Page 8 Current November 2013