maritime event application form · maritime event application form page 1 of 3 maritime event...
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Page 1 of 3 Maritime Event Application Form
Maritime Event Application Form
Important
Email completed applications to the [email protected] or telephone 09 362 0397.Applications must be submitted a minimum of 4 weeks prior to the event date, or the application may be refused.Please ensure that you have prepared/supplied all of the undermentioned items BEFORE submitting your application.
Completed application form
Full details of the event/activity including location, date(s), times, area of operation
A detailed nautical chart or map of the area in which the event/activity is to take place
Evidence of a hazard management plan in relation to the event, undertaken by the applicant, in which all risks associated with the event have been identified and managed (see ‘On Water Event Hazard Management Plan’ for example).
An operational plan detailing safety procedures, rescue craft, qualified personnel in attendance and communications procedures
A copy of the applicant’s Public Liability insurance policy, clearly identifying details of the insurer, the amount of the insurance cover, any relevant exclusions and the policy expiry date
Proof of identity for the applicant. e.g. drivers license
A copy of the Application For A Test Certificate For An Outdoor Pyrotechnic Display Work – if applicable
Written authorisation from the occupier/trustee of the foreshore land intended to be used in connection with the proposed event/activity – if applicable
Details of Applicant
Surname Given names
Organisation (if applicable) Position held (if applicable)
Physical address
Postal address (if different from physical address)
Suburb Post code
Private ph ( ) Business ph ( ) Mobile ( ) Facsimile ( )
Email:
Contact Details for the On Water Safety Officer
Name Telephone ( )
Email Mobile ( )
Applicant’s Declaration
I declare that I am authorised to act as the applicant for the purpose of the maritime event and that the information supplied is true and correct. I understand that if any detail is found to be incorrect the maritime event may be cancelled by the Auckland Council Harbourmaster without notice.
I declare that as the applicant for the maritime event, I will implement strategies to alleviate all risks associated with the maritime event and that Auckland Council is indemnified and released from all liability in this regard.
I agree to abide by any conditions that Auckland Council may impose on the exercise of its grant of this application.
Applicant’s signature
Date / /
Maritime Event Number (HM use)
Page 2 of 3 Maritime Event Application Form
Maritime Event/Activity(Detailed nautical chart or map of the area must be supplied)
Area of operation (waterway) Location (specific area)
Dates - Start / / Finish / /
Times - Earliest start • Latest finish (include set up/pack down time required on the water) •
Maximum no. of participants/vessels •
Do you require a reserved area (on the water) for your maritime event/activity?
No
Yes (please attach supporting documentation to justify this).
Additional fees may be incurred for publishing a public notice in relation to reserving an area and/or uplifting any other Navigation Safety Bylaw.
Are you using any foreshore or adjacent land in conjunction with this event/activity?
No
Yes - please supply written consent from Auckland Council or the land owner
For fireworks – is there any objection to the public being notified?
No – If no, the public may be notified by Auckland Council
Yes – If yes, please state the reasons
Type of event (Choose only one section)
Sailing type events Code
Sail races SA1
Sail regatta SA2
Sail training SA3
Sailboard races SA4
Sail race (offshore) SA5
Kite boarding races SA6
Power boats events Code
Power boat races PB1
Power boat offshore races PB2
PWC races PB3
Thundercat races PB4
Water ski races PB5
Fireworks display Code
Fireworks display FW1
Swim type events Code
(includes swim leg of biathlon, triathlon, as well as swim events)
SW1
Other Code
Dragon boat races OT1
Waka Ama OT2
Stand Up Paddle Boards OT3
Rowing OT4
Kayaking OT5
Demonstration/display OT6
Filming OT7
Other water activities/races OT8
Please specify
Page 3 of 3 Maritime Event Application Form
Insurance Requirements
• The maritime event applicant (applicant) expressly and unreservedly indemnifies Auckland Council from all liability associated with the maritime event/activity (event) and releases Auckland Council from any actions, of whatsoever nature, that may be instituted in relation to the event. Acceptance of this requirement constitutes irrevocable acceptance of this condition.
• It is a requirement that the applicant must clearly advise all participants in the event whether or not they are covered by the applicants insurance should they sustain an injury or loss as a result of participating in the event and provide details of the coverage.
• To protect the applicant against claims made by a third party, all applicants must hold a Public Liability insurance policy that covers the event, including all participants in the event and damage to any vessels or property associated with the event.
• It is also a condition for the applicant that a written warning must be given to all participants by the applicant in relation to the particular risks associated with participating in the event and written acknowledgement of these risks must be obtained from the participant. The warning and acknowledgement can be included on the application form completed by the participant.
Privacy Act 1993
The information collected in this form will be used to ensure the effective facilitation of the event. It will be distributed to other council departments, external agencies and will be used for public information as required.
Harbourmaster Regional Offices
Auckland
3 Solent StreetMechanics BayAuckland 1010
Orewa
50 Centreway RoadOrewa 0931
Sandspit
Wharf officeSandspit Road Warkworth 0982
[email protected] or telephone 09 362 0397.