Online Form - Event application - part 2

A Town of Bassendean Environmental Health officer has categorised your event as medium or high-risk.

As such, the form below must be completed at least eight weeks prior to the event.

Local councils require this information to ensure your social gathering is lawful, meets all relevant safety standards, and complies with the Department of Health event guidelines.

We thank you for adding vibrancy to the area and look forward to completing your application assessment.

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EVENT DETAILS

Event name

Day/Date

Contact Person

TOILET FACILITIES

Types of toilet facilities proposed.

MaleFemaleUniversal Access

Are any of these facilities temporary (portaloos)?

YesNo

Male toilets

# of cubicles

# of hand basins

Urinals (# of metres)

Female toilets

# of cubicles

# of hand basins

Universal access

# of cubicles

# of hand basins

CROWD CONTROL

Note: Crowd control for medium risk events should follow a ratio of 1 controller/200 patrons. For higher risk licensed events event organisers should employ a ratio of at least 2 crowd controllers for the first 100 patrons and then 1 crowd controller for each additional 100 patrons or part thereof.

NA as there will be less than 200 attendees throughout the duration of the event.

# of crowd controllers proposed

Name of company supplying crowd controllers

PARKING, TRANSPORT & TRAFFIC

Describe parking arrangements (where, how directed etc)

FIRST AID

First aid services are generally not required for low-risk events that are smaller than 500 patrons on the condition that the event is near central ambulance/hospital services and:

one of your team members has a current recognised first aid certificate from an accredited provider.

# of first aid proposed

Name of company or team member supplying first aid

Please attach your team member's First Aid certificate (if applicable)

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PROHIBITED ITEMS

What items will be prohibited from the event (alcohol, food/drink etc)?

How are attendees notified of these restrictions prior?

RUBBISH REMOVAL & SITE CLEANING

Describe rubbish removal and site cleaning arrangements

CERTIFICATIONS

A licensed electrician is required to check all electrical installations such as lighting towers, extension cords, generators etc. The licenced electrician must complete a Form 5 Certificate of Electrical Compliance on the day of the event when all electrical installations are complete. The Certificate of Approval cannot be granted if this has not been carried out.

Name and contact details of the licensed electrician who will be carrying out the works

All structures such as stages and marquees (excluding market tents) are required to be certified by a structural engineer or a parson with sufficient experience or qualifications. The Certificate of Structural Sufficiency form is required to be completed only when ALL structures have been erected and checked by this person.

Name and contact details of the person who will be certifying each structure

NOISE

What provisions have you made to minimise and monitor the level of noise? Please consider the layout of speakers, location of generators, nearby dwellings, finish time of the event and ushering patrons from the event when it has finished.

FOOD STALLS/VEHICLES

NA as there will be no food stalls/vehicles

List all food stalls/vehicles that will be trading at the event including their contact details. This includes anyone selling hot food, cold food, pre-packaged food, ice-creams, beverages, home-made condiments, confectionary etc.

Important note: all food stalls/vehicles are required to make a separate application to the Town’s Health Section to sell food at this event. An application fee and a trading fee are applicable. Only approved food stalls/vehicles are permitted to trade.

ALCOHOL

Alcohol availability

Liquor licensee contact details (if applicable) Please provide their name, address and phone number

CONTACT/S DURING THE EVENT

Primary Contact Person:

Contact Number:

CHECKLIST

Please use the below checklist to ensure relevant items for your event have been completed and forwarded to the Town of Bassendean within the relevant timeframe. This will ensure there are no delays in processing your event application.

Due 8 weeks prior to the event:

Event Application Form

Emergency Evacuation Plan

Upload emergency evacuation plan

Max File Size: 10.00 MB
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Site Plan: Initial Draft (only required for events with greater than 1,000 attendees)

Upload site plan draft

Max File Size: 10.00 MB
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Due 60 days prior to the event:

Regulation 18 Application for Non-Complying Event (Noise) if applicable

Due 4 weeks prior to the event:

Endorsed Traffic Management Plan if applicable
Risk Management Plan for events with greater than 1,000 attendees
Site Plan: Initial Draft for events with less than 1,000 attendees
Copy of Music Licenses from APRA and PPCA if applicable
Food Applications if applicable
Amusement Devices – Current Inspection Certificated, WorkSafe Plant Registration Number or Class 1 Certificates, photographs, Public Liability Insurance if applicable

Due 2 weeks prior to the event:

Copy of Public Liability Insurance
Parking & Transport Management Plan if applicable
Disability Access and Inclusion Plan
Notification Letter to Businesses and Residents if applicable
Key Personnel Contact List
Waste Management Plan
Security Details and License Numbers

Due on the day of the event, prior to opening:

Structural details and certification of structures (eg tents, marquees, stages, scaffolding, seating, lighting towers etc) if applicable
Form 5 Electrical Compliance if applicable

APPLICATION FEES

	Risk level
Admission fee	Medium risk	High risk
No admission fee	Nil	$832
Admission fee	$260	$832

Note: these fees are non-refundable.
Additional Reserve Hire Fees, Health Fees, Amusement Operator Fees, Liquor Permit Fees and Bonds will be charged separately.

Payment can be made by the following methods, please indicate your preferred method.

In-person before 4:00pm at the Town of Bassendean Customer Service Centre (35 Old Perth Road, Bassendean)

By cheque made payable to the “Town of Bassendean” and posted to PO Box 87, Bassendean WA 6934

By Credit Card (the Town of Bassendean will contact you directly to obtain your credit card number)

STATEMENT

I declare the information provided in this application is true and correct. I have read and understand the Event Guidelines and are authorised to accept them on behalf of the event organiser named previously. I have attached the appropriate forms and site plans.

Please note that submitting this application does not secure event approval. You will be contacted for further information.

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