Event Permit Application

If you experience any difficulties completing this form please contact us on 02 6023 8111 or email info@alburycity.nsw.gov.au

Applicant

Organisation Name (if applicable)

ABN (if applicable)

Town

State

Postcode

Daytime Phone

Mobile

Event Title

Event URL (Event Website/Facebook Page etc)

Estimated Numbers of attendees

Can the general public attend the event?

Yes No

Is the event ticketed?

Yes No

Description and/or purpose of the event Please: Be as descriptive as possible and include objectives, target audience, type of activities

Background support documentation for the event, e.g. promotional material, site plan etc if any (optional)

Event Set up Date

Event Set up Time

Event Start Date

Event Start Time

Event Dismantle Date

Event Dismantle Time

Refer to the below downloadable maps or use the geolocation search for more information on specific parks and reserves and relevant lawn and hardstand area numbers (if applicable).

Hovell Tree Reserve Plan

Noreuil Park Plan

QEII Square Plan

Name

Latitude

Longitude

Formatted Address

Route

Street Number

Postal Code

Locality

State

Reference

URL

Marquee/s or other structure/s Food Truck/s (including BBQ) Stage

Generator Amusement Rides Fireworks

Toilets Animals Inflatable structures

Patrons BYO Catered Sales

Food and beverages Alcoholic beverages Merchandise

Power (additional charges may apply) Water (additional charges may apply) Waste management (additional charges apply) Toilets refreshed (additional charges apply)

Please attach Certificate of Currency for Public Liability Insurance to the value of $20 million plus extended to cover your event

AlburyCity asks you to provide your personal details and event documentation so that we may properly assess your Event Permit Application. For more information about what data we collect, why we collect it, and what we do with it refer to our Privacy Policy.

I have read and agree to the terms and conditions as outlined by AlburyCity.