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Event Organiser's Details Event Details for OFFICE USE ONLY FOR OFFICE USE ONLY HEALTH & SAFETY Outdoor Entertainments Events Guide issued Yes Date form sent to Organiser with site map Date returned Event Safety & Guidance Notes issued Event Organiser’s Details Event Details ES1 GN1 GN16 Site ES2 GN2 GN17 Name of Organisation promoting event Event date(s) ES3 GN3 GN18 Tick box if this is the first time an application has been submitted for this event in Birmingham ES4 GN4 GN19 FUNFAIRS ES5 GN5 GN20 Committee approval Yes No ES6 GN6 GN21 Funfair Subsidy cheque received Yes Date Name of Event Organiser ES7 GN7 GN22 Name of site required ES8 GN8 GN23 ES9 GN9 GN24 Identify which area of the site you wish to use ES10 GN10 GN25 Address DEPARTMENTAL OFFICERS, PLEASE NOTE Note any comments from the Ranger Services Manager ES11 GN11 GN26 below, and add any concerns you may have regarding ES12 GN12 GN27 Date(s) of event the event (access, parking, ground conditions, toilet GN13 GN28 facilities, residents, etc.) GN14 GN29 Date(s) setting up Event Approved Yes No GN15 GN30 Date leaving the site Print Name Copy of Public Liability Insurance provided Yes Daytime Tel No. Event time From To Signature Date Insurance Company Evening Tel No. Policy No. E-Mail Address Type of event, please tick relevant box Angling Competition (Peg fee required) DATA PROTECTION ACT 1998 Boat Race APPLICATION CIRCULATION Your details may be passed on to groups such as Car Boot Sale (permission is also required from majorettes, face painters, etc., who wish to contact the you to participate in your event. If you DO NOT want Geoff Cole, Assistant Director City Council’s Environmental and Consumer your details passed on for this reason, please tick box Services Department, telephone 0121-303 Kevin Brown, Head of Special Events 8222). Anne Angell, Pitch Bookings Officer (Sport) Car Parking only Mike Greenfield, Funfairs/Circuses Carnival/Fair Ron Stretton, Safety Officer Circus Franchise Caterer Please give details about the Organisation Cultural Event West Midlands Police promoting the event, or attach information. Specify______________________ Ward Councillors Information attached Yes No ___ Edgbaston & Northfield Erdington & Sutton Sport Event Specify______________________ Karen Cheney Peter Jones ___ Patrick Tarry John Biddle Dog Show Joe Hayden (LHCP) John Porter (SP) Duck Race Jon Clarkson (WVCP) Fun Day Hall Green & Selly Oak Hodge Hill & Yardley Playscheme Gary Abraham Colin Usher Religious Meeting Simon Cooper Mike Wheale Sponsored Walk/Run John Greenhouse (CHP) Steve Nelson (SCP) Vehicle Rally/Show mac Facilities Co-ordinator Leo McKevitt (PK) Other Mike Hinton (KHP) Ladywood & Perry Barr Sparkbrook & Small sFUNDRAISING FOR CHARITY H’th If the event includes fundraising for charity, Mike Merrigan Diana Wheeler please supply the registration number of the Pete Smallwood Peter Short charity, and send written confirmation from the Gordon Addis (ER) charity’s local office to confirm proceeds from the Gary McManus (HP) event will be donated to them. Approval for the Aston Hall Manager event will not be granted unless this information is supplied. Alexander Stadium Manager Charity Registration Number Information attached Yes No PUBLIC LIABILITY INSURANCE rADMISSION CHARGES FUNFAIRS MUSIC This is an essential requirement for all events (see Give details of any admission charges (ie. purchase Please state number of each of the following A Public Entertainment's Licence is required for Condition 2). Adequate cover provided by such of a ticket/programme, etc), and state the charge for music, singing and dancing events to which policies is normally in the region of £5 million, and the following Adult funfair rides (see below) members of the general public are admitted. arranged through an Insurance Broker by the Children’s funfair rides Contact the City Council’s Environmental and Event Organiser. Approval to hold the event will be Consumer Services Department for advice on refused if you fail to provide this information. Children’s amusement rides* 0121-303 8222. Copy of certificate enclosed Yes No Stalls Give details of any music to be included (ie. (*Donkey rides, bouncy castle, etc) popgroup, band, records) other than at any A copy of the insurance certificate must be funfair. provided before the event takes place, however, is Name and address of Funfair/Amusements not imperative it is included with the application at Children Adults Operator this stage. ABOUT THE EVENT Give a brief description about the event Æ CATERING If hot/cold food or drink is to be supplied, please give details aELECTRICITY It is recommended that where electricity is required, this is provided by the use of generators. Give details if a mains electricity supply is required (see Condition 7), and state To receive financial support from any funfair the type of apparatus to be connected to the using adult rides, an Event Organiser must agree supply. to certain Conditions of Subsidy (see Condition 13). This is a process of validation that safeguards the interests of Event Organisers, Funfair Operators and the City Council. If a licensed bar is to be operated, please supply Amount of agreed Subsidy name and address of Licensee This must equal or exceed the amount a funfair Number of 13 Amp outlets would pay in rent for the same period, for the required same number of adult rides. Approx. load (Amp) of each Your chosen Funfair Operator must send in a cheque as soon as possible so you can receive the Subsidy before the event. You must supply the OTHER PERMISSION City Council with a set of accounts after the Please add any items for which permission is event, detailing what the Subsidy was used for. sought, which are not mentioned previously (ie. Cheques and account details should be sent direct erection of temporary structures such as to Mike Greenfield, PO Box 2122, 13th Floor marquees, etc). Alpha Tower, Suffolk Street, Queensway, Birmingham B1 1TZ (Telephone 0121-303 3011). Ê CAR PARKING Your organisation must have a bank account for Please give details of any car parking arrangements the cheque to be paid into. Name of bank account Address to send cheque DECLARATION v ATTENDANCE I have read, understand, and accept the Tick appropriate box to indicate your anticipated Conditions relating to the use of land under the attendance figure (maximum number of people at control of Birmingham City Council’s Department any one time/per performance) of Leisure and Culture. I hereby apply for the use of the site on the date(s) indicated, and agree to Upto 50 400 - 500 comply with the directions of the Department of 50 - 100 500 - 1000 Leisure and Culture or its representatives. 100 - 200 1000 - 2000 Print Name 200 - 300 More than 2000 300 - 400 If more than Position in Organisation 2000, Signature Date please specify .
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