Fillable Health And Safety Events Safety Advisory Group Form (Peterborough City Council)

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Health And Safety Events Safety Advisory Group Form (Peterborough City Council)

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Event Safety Advisory Group
If you are proposing to hold an event or one which involves a large gathering of people. The Peterborough City
Council Event Safety Advisory Group (SAG) would like you to provide basic details of your event by completing
this form. This will allow the Council, emergency services (Police, Fire and Ambulance) and Highways to assist
with their planning and provide you with advice on a range of issues including safety, street closures and
licenses required.
Please complete and return the form as soon as possible.
Resilience Team, Peterborough City Council. Town Hall, Bridge Street, Peterborough, PE1 1HF
Email: resilienceteam@peterborough.gov.uk
Use additional sheets if necessary. Please do not wait until the details of your event are nalised.
1. Event Details
Please complete using block capitals and black ink.
Event name
Copyright © 2013 Peterborough City Council Version 1.1 (11/10/2013)
Event
Duration:
Event site
address:
Postcode:
Is the event being held on
Council land?
Has permission for hire of
land been requested?
Start (Date/Time)
Time & Date of
Occupation (Set-up)
Time & Date of
Occupation (Take down)
Yes
No
Yes
No
Event website
address
Please state the maximum
number of people at any one
time that you intend to allow to
be present during the event.
Public Staff Performers Volunteers
(if applicable)
Total
Target audience age and range
dd / mm / yyyy HH : MM
End (Date/Time)
dd / mm / yyyy HH : MM
dd / mm / yyyy HH : MM
dd / mm / yyyy HH : MM
Event Details (continued)
Please provide details of the event below including any other relevant details.
Temporary structures
Please provide details of any temporary structures, including size and details of providers below.
Inatables
Will you be hiring inatable attractions for the event? i.e. bouncy castle
If YES, please provide details, it will be expected that such structures will be included within your event risk
assessment.
Insurance
Please provide details of insurance cover below including Public Liability / Third party risks and attach a copy of
certicate, where available.
Copyright © 2013 Peterborough City Council Version 1.1 (11/10/2013)
Yes
No
First Aid Provision
Have you undertaken a medical risk assessment?
If YES, please provide contact details of supplier and numbers:
Security / Stewards / Marshalls / Crowd Control
Are you planning to engage security stewards etc.
If YES, please give details of the company employed and numbers to be deployed.
Alcohol
Will alcohol be available on site?
If YES, please provide full details
Performances
Will the event include; public dancing / Karaoke / live bands / disco?
If YES, please provide full details
Copyright © 2013 Peterborough City Council Version 1.1 (11/10/2013)
Event Details (continued)
Yes
No
Yes
No
Yes
No
Yes
No
Copyright © 2013 Peterborough City Council Version 1.1 (11/10/2013)
2. Event Activities (optional)
Please tick the appropriate activities you intend to utilise or permit at the event. The provision of an event
timetable would also be helpful. We will expect you to cover these activities in more detail in your risk
assessment:
Fireworks / pyrotechnics Live music
Carnival / procession Live entertainment
Fairground Equipment / rides Lost Child Point
Aircraft Horses / Donkeys other animals
Parachutists Re-enactment Groups
Hot Air Ballons Living history or other
Balloon Launch Toilets
Inatables (e.g. bouncy castle) Drinking water on site
Motorcycles Food / Drink concessions
Other motor vehicles Power supply
Portable generator Barbecue
Bonre Portable staging
Market Stalls PA system
Camping On site communications
Water related activities Barrier / fencing
Other(s) (please specify):
3. Environment
Public Rights of way
Please state whether there are any footpaths, bridleways or roads that are normally open to the public affected
or used as part of the event?
Directional signage
Please state whether you are proposing to make use of directional signing on the highway to direct the public to
the event?
Road Closures
Please state whether or not you anticipate the need for any road closures or trafc diversions
Parking on the highway
Please state whether or not you have made any considerations for the restriction or control parking on the
highway in the vicinity of your event?
Parking (location)
Where are you expecting the majority of the public to park?
Parking (spaces)
Please state the amount of allocated parking spaces for the following:
Event Staff External Staff Public Total
Copyright © 2013 Peterborough City Council Version 1.1 (11/10/2013)
Vehicle movements
Please state whether any vehicles will be driven across anything other than roads?
If YES, please state what type of vehicles, for what purpose and how many?
Toilets
Please state whether there will be toilets available on site / premises
If YES, please provide details of the facilities, and if applicable any details of providers.
If NO, please provide details of a suitable alternative e.g. existing onsite public toilets.
Other details
Please provide any other relevant details of the event, which may be detrimental to the environment
and/or surrounding environment of the site / premises.
Yes
No
Copyright © 2013 Peterborough City Council Version 1.1 (11/10/2013)
Yes
No
Copyright © 2013 Peterborough City Council Version 1.1 (11/10/2013)
4. Contact details
Please provide details of the main contact / site manager / other
Title
Surname
Forename(s)
Address
Postal town
Post code
Telephone numbers
Daytime
Evening*
Mobile*
Fax*
* optional
Title
Surname
Forename(s)
Address
Postal town
Post code
Telephone numbers
Daytime
Evening*
Mobile*
Fax*
* optional
Email
Your details
Event manager details
Email
Alternative contact details (If you provide alternative contact details, we will use these in preference to those
provided above)
Alternative contact details (If you provide alternative contact details, we will use these in preference to those
provided above)
Peterborough City Council is registered under the Data Protection Act 1998 for the purpose of processing personal data in
the performance of its legitimate business. Any information held by the Council will be processed in compliance with the eight
principles of the Act. Information you have provided may be shared with other public sector organisations for the prevention and
detection of fraud. Further information relating to your rights under the Data Protection Act can be sent to you on request.
Data Protection Act 1998
Copyright © 2013 Peterborough City Council Version 1.1 (11/10/2013)
Document Checklist
The following documents have been enclosed.
At least one copy of the risk assessment for the above listed event.
Copy of stand alone re risk assessment.
At least one copy of the site plan for the above listed event.
Details of insurance that will cover the above listed event, employees, public, and value.
Including all relevant certicates and documentation.
Details of medical/rst aid cover that will be present at the above listed event.
All details of any company that is providing staff for the event including stewarding, security etc.
Any/all licences details relevant to the above listed event and/or premises.
Any other management control documents.
5. Declaration
I conrm that the above details are correct and that I am over 18 years of age. I also conrm that any/all relevant
licenses have been and/or will be applied for prior to the event.
Signed:
Print name: Date (DD/MM/YYYY)
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Health And Safety Events Safety Advisory Group Form (Peterborough City Council)

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Completed 16 July 2020

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