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011 854 3166
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084 0786 911
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Event Organiser Name
Email
Phone
Name of event
Address of event
Date of event
Please tick all applicable boxes
Standing/Seating
Seated
Standing
Mixed
Nature of Event
Classical Performance
Public Exhibition
Pop/Rock Concert
Rave/Disco Concert
Agricultural/Country Show
Marine
Motorcycle Display
Aviation
International Event
Motor Sport
State Occasion
VIP visit/Summit
Music festival
Bonfire/Pyrotechnic display
New Year Celebrations
Demonstration/March
Sports event with low risk of disorder
Sports event with medium risk of disorder
Sports event with high risk of disorder
Opposing factions involved
Additional Activities/Harzards
Carnival
Helicopter
Water Hazard
Parachute Display
Street Theatre
On-site Alcohol Use
Expected Attendance
< 1 000
< 3 000
< 5 000
< 10 000
< 20 000
< 30 000
< 40 000
< 50 000
< 60 000
< 70 000
< 80 000
< 90 000
< 100 000
< 200 000
< 300 000
Venue
Indoor
Stadium
Outdoor in a confined location
Widespread public location in streets
Temporary outdoor structures
Includes overnight camping
Audience Profile
Predominately children and teenagers
Predominately young adults
Predominately the elderly
Mix, in family groups
Mix, not in family groups
On site facilities available
Suturing, Plastering or Both
Vending machine for over the counter medication
Automated external defibrillator (AED)
Existing full-time operational medical facilities on-site
