Fillable Parks & Open Spaces Security Key Form Long (Queenstown Lakes District Council New Zealand)

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Parks & Open Spaces Security Key Form Long (Queenstown Lakes District Council New Zealand)

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Country of origin: NEW-ZEALAND
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Parks & Open Spaces Security Key Form – Long Term
Council Contractors and Staff are expected to respect all Council policies and bylaws.
QLDC keys are issued to Contractors with permission from Council.
All keys lost/not returned will be charged at a rate of $250.00 per key.
All Council playgrounds and sports grounds are smoke free zones. We ask you to respect this policy.
Name of Ground/ Reserve:______________________________________________________________________________
Company: ____________________________________________________________________________________________
Name: _______________________________________________________________________________________________
Contact Number: _____________________________________Email: __________________________________________
Reason for Use:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Issue Date: ____________________________ Return Date: __________________________
I__________________________________, the undersigned accept that if the QLDC security key that I have been temporarily
issued is lost and/or not returned to the Queenstown Lakes District Council, will be responsible for the charge of $250.00 per
key.
Signature: _____________________________
Date: _________________________________
Reserve Access
I______________________________, the undersigned accept that if any damage, loss or harm is caused to Council land or
assets whilst I access this reserve/track or park; will be responsible for all damage and costs incurred which will be at the
discretion of the Parks Manager of the Queenstown Lakes District Council.
Signature: _____________________________
Date: _________________________________
Please take before and after photos.
All keys lost/not returned will be charged to the user at a rate of $250.00 per key.
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The above name/business when accessing an Open Space area or Council asset with the authorised Council Key must ensure
that all vehicles accessing tracks, trails and green spaces are to have a current NZ or approved foreign driver’s license.
Hazards lights or amber flashing beacons are to be turned on before entering the area and remain active until the vehicle
leaves the area or is parked
Marker cones or signs are to be installed at all entry/exit point where possible. The vehicle speed is not to exceed 5km or a
lesser speed as required by either track conditions or pedestrian numbers and behaviour.
Vehicles are not to have any materials or objects protruding from the footprint of the vehicle.
Allow 1.5 meter clearance when passing a pedestrian if possible, or slow to a speed that allows you to pass pedestrians or
cyclists safely. If the pedestrian or cyclist has not acknowledged the vehicles presence please tap the horn to alert from a
safe distance, do not use the horn in a way that will frighten anything.
Areas of ecological significance are to be avoided. Repairs are to be undertaken to any damage to the surface or turf caused
by the vehicle use.
_____________________________________________
Office Use Only
Name of staff member issuing key: ________________________________________________________________________
Position/Department: ___________________________________________________________________________________
Cost of Replacement: __$250.00 per key____________________________________________________________________
Signature: _____________________________________________________________________________________________
KEY ID NUMBER:
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25 January 2021
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Parks & Open Spaces Security Key Form Long (Queenstown Lakes District Council New Zealand)

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Completed 11 February 2021

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