Operator Name

Activity Schedule

Pre & Post Event Access (If Required)

Proposed Area For Use (Please attach .GPX File or JPEG of Map)

Activity Type (e.g. What type of activity is the application for? For example "Sporting Competition").

Activity Description

Briefly outline details of proposed Activity including activity details, number of people, vehicles involved and facilities you propose to use eg: trails, roads.

Insurance

Applicants must hold public liability insurance for no less than $10,000,000. HVP Plantations must be listed as an interested party indemnified against any action out of or in respect of the permit to the use of the land. Please attach valid certificate of currency.

Operator Manager/Key Contact

Application Type

Applicants must provide an Activity Plan that considers the following:

Overview ie: participant numbers, temporary structures, waste management, bathroom facilities, lighting, power,

Activity Run Sheet - including pre and post activity conducted within the plantation

Traffic Management - ie: parking, vehicle management, use of vehicles

Emergency Management - ie: first aid, evacuation procedures

Communication - ie: briefings, equipment (UHF radio), resident/stakeholder notification

Community Value - Document value of event to community ie. use of local service providers (catering etc.)

Hancock Victorian Plantations Pty Limited and Grand Ridge Plantations Pty Ltd (collectively “HVP”) is committed to safety. The following terms and conditions are designed to help ensure you have an enjoyable and safe experience on HVP land.

It is a condition of entry to HVP land that you as a Permit Holder (and any members of your group) agree to abide by the terms and conditions set out in the Visitor Induction Guidelines and the additional terms and conditions set out in this permit. You may be asked to leave HVP land if you breach any of these terms and conditions.

I agree to the terms & conditions ourlined in this pllication. I have fully read and submitted a Visitor Induction Agreement and I have provided all requested information.