Darebin Street Parties Program Application Form - City of Darebin

Darebin Street Parties Program Application Form1. Applicant’s DetailsName: ..Address: ..Suburb/postcode:...........................................Telephone: ..Email: ...2. Event DetailsDate of street party: Time to..Venue for street party:.Have you informed your neighbours of your intention to hold a Neighbourhood Partyin your street?□ Yes □ NoNumber of residents invited to attend: .Have you applied to Darebin City Council to host a street party in the past?□ Yes □ NoWill there be music?□ Yes □ NoBrief overview of proposed event:3. Insurance and SafetyDarebin City Council has a limited number of FREE public liability insurance policieseach year. Do you require public liability insurance to be organised by Darebin CityCouncil for your Street Party? Yes □ No □If yes, it is a requirement that you complete the risk register below

If you would like to gain and pay for your own public liability insurance please ensure youattach a copy of this policy on your application form.Risk ManagementTo ensure the safety of everyone attending your Street Party and in order to obtain publicliability insurance from the Darebin City Council you are required to complete a risk register.Please consider the possible risks to public safety and how these risks might be avoided orminimised. Use the following table to list the possible risks to public safety and the thingsyou will do to minimise or avoid these.Some possible risks you might consider:. trips or falls over equipment. sun exposure on hot days. burns from the BBQ. alcohol consumption. injury from games & recreation equipment etc. hygiene & food handlingRisk to public safetyWhat you will do to minimise or avoid this risk?

Please post your application form to:Community Access Health and Safety UnitCity of DarebinPO Box 91Preston VIC 3072Council is committed to protecting your privacy. Any personal information collected will only be used by Council for thepurposes of processing this Expression of Interest Form so that Council can facilitate this Community Safety Month activityand thereby service the needs of the Darebin community. Council will not disclose this information to any other individual ororganisation unless requested by law. For further information please see the City of Darebin Privacy Policy atwww.darebin.vic.gov.au.Office Use OnlyCommunity Access, Health and SafetyDate Application received.Assessing officerDate of reply to Applicant.Public Liability required: Yes No Public Liability Reference Number.Street Closure: Yes No Notification to residents of road closure Yes No Traffic ServicesEvent dateStart/ Finish../Date of drop off............Officer...Date of collection..OfficerOther requirements.

The Darebin Street Parties Important Information1. All residents who apply to hold an event through the Darebin Street PartiesProgram are encouraged to obtain public liability insurance. Residents musteither have a Certificate of Currency which must be supplied to Council with theapplication form or you must apply to the City of Darebin to arrange PublicLiability Insurance (A limited number of free polices are available each year).2. Residents must complete a risk register in order to receive Public LiabilityInsurance from the City of Darebin.3. It is not legal to sell food or alcohol at a street party without obtaining permits.This process is not covered in this guide. For more info contact Darebin CityCouncil 8470 8888.4. Council assumes no responsibility for residents who do not cover their event forpublic liability insurance, in the event of an accident, damage or any other issueoccurring during the hosting of a street party.5. Residents who wish to close their street are required to complete a Road ClosureApplication section and obtain public liability insurance.6. All residents affected by the street closures must be informed of the proposedstreet closures including all those that Council considers may be detrimentallyaffected by the granting of the application. You must have agreement from 75%of affected residents.7. Residents are required to dismantling road closure equipment and leaving theequipment in a safe place until the equipment is picked upon the followingMonday.8. Residents undertake the responsibility for ensuring that the street/s andsurrounds are left in a clean and safe.9. Noise, including amplified noise, must be kept at a reasonable level so as not tocause annoyance to other persons.10. Certain Council activities will be conducted to provide data and information forevaluation at the end of the program.