LisburnCastlereaghCity Council
Safety Advisory Group
Event Notification Form
May 2017
Version 6 /

The LisburnCastlereaghCity Council Safety Advisory Group (SAG) would like you to provide basic details of your event by completing this form in type, or writing in block capitals. This will allow the Council and emergency services (fire, ambulance and police) to provide you with advice on safety, street closures and licences to assist with your event planning. Please return the completed form as soon as possible. Do not wait until the details for your event are finalised.Please complete all sections fully

Event Details
1. / Name of Event:
2. / Event date(s): / Start Time / Finish Time
3. / Event Location:

(Please enclose a site plan showing proposed positions of stalls, marquees, arena, exhibition units, car parking would also be helpful.)

Location Plan attached /  / and/or Site Plan attached / 
Brief Description of Event Proposed:
4.Date/time to enter site to start preparation:
5.Date/time the site will be vacated after the event:
6.Does any part of the event take place outside or in a temporary structure e.g. a marquee?
(Please tick) Yes No
7.Specifically is the event (please tick one box only)
Commercial /  / Fund raising /  / Community Service Event / 
Charity event /  / Name of Charity:
Charity Registration Number:
Is the event limited to friends/relatives? / Yes /  / No / 
(in the case of a school to staff/children/parents?)
Is the event free? / Yes /  / No /  / Admission Price? £
Will you be selling programmes? / Yes /  / No /  / Price? £
8.Is funding being provided by any statutory, community or charitable organization?
(Please tick) / Yes /  / No / 
If the answer is YES please write the name of the organization and address below:
9.Estimated maximum number of people attending:
10.Anticipated age of audience, e.g. children, youths, families, adults:
Alternative Arrangements
12.Is there a possible alternative site? / Yes /  / No /  / Where?
13.Is there a possible alternative date? / Yes /  / No /  / When?
Contact Details of Organiser
14.Name of Organisation?
15.Name of Person in overall control at event?
Deputy/ies:
16.Contact Address / Postcode:
17.E-mail Address:
18.Telephone Number: / Mobile:
Documentation/Administration
Prior to Event
Yes / No
Does the event organizer own the site/venue? /  / 
If no, does the event organizer have written agreement from the owner and has proof been provided?
(Please provide copy of written agreement from the owner of the site/venue) /  / 
Has the site/venue been used before for similar events? /  / 
Have residents or local communities been consulted? /  / 
If yes, was the communication written? /  / 
Has a specific ‘Event Management Plan’ and/or ‘Traffic Management Plan’ been produced for the proposed event? (Please provide copy) /  / 
If yes, who is the author(s) of the Event Management Plan?
Is the author(s) deemed competent in relation to experience, qualification and knowledge for this type of event?(Must be completed) /  / 
If yes, detail the experience and qualifications of this person?
Who has provided indemnity insurance for the event plan?
Has formal contact been made with any other statutory agencies? /  
Has a multiagency meeting been planned? /  
If yes, please provide date of meeting.
If yes, please provide the name of who you have been in contact with?
PSNI / Police Service of Northern Ireland
NIAS / Northern Ireland Ambulance Service
NIFRS / Northern Ireland Fire and Rescue Service
Have Medical cover/First Aid arrangements been provided? /  / 
Has someone been nominated for collecting all certification? /  / 
If yes, what is the name, experience and qualifications of the nominated person?
Are there specifications, schedules and contracts written and agreed with artists and suppliers? /  / 
Is there a competent person nominated to supervise the Build Break Down of the event?(Must be completed) /  / 
If yes, what is the name, experience and qualifications of the competent person?(Must be completed)
Have all relevant statutory approvals, licenses, etc. been granted? E.g. Entertainment Licence, LiquorLicence, Children’s Certificate. /  / 
Roads/Highways and Traffic Implications

If you answer YES anywhere within this section then a plan is required detailing your proposals.

19.Are any:footpaths / Yes /  / No / 
roads / Yes /  / No / 
that are normally open to the public affected or used as part of the event?
20.Are you proposing any directional signing on any roads to direct the public to the event? / Yes /  / No / 
21.Do you anticipate the need for any road closures/traffic diversions? / Yes /  / No / 
22.Have you considered the need to restrict or control parking on any road in the vicinity of your event? / Yes /  / No / 
23.Are there any public car parks to be closed in order to hold the event? / Yes /  / No / 
24.How many parking spaces will be available for persons working at the event?
25.How many dedicated parking spaces will be available for the public attending the event?

IMPORTANT NOTES

(1)If a formal traffic order is required, you must contact the Department for Regional Development and allow a reasonable time period for them to process the order.

(2)A request for a road closure does not automatically guarantee one will be granted. The Traffic Management Team will need to be satisfied that the event will not cause anyunnecessary risks to road users and pedestrians or create unnecessary traffic congestion.

Event Activities

26.Please tick the appropriate boxes to show the activities and facilities you intend to utilise or permit at the event (some of these may not be permitted at all sites)

Fireworks/Pyrotechnics /  / Live Music / 
Carnival/procession /  / Live Entertainment / 
Fairground equipment /  / Lost children point / 
Aircraft /  / Barrier/fencing / 
Parachutists /  / Marquees / 
Balloon launch /  / Portable Generator: Petrol /  / Diesel / 
Hot Air Balloons /  / Power Supply / 
Horses/Donkeys/Other Animals /  / Alcohol / 
Motor Vehicles /  / Food/Drink Concessions / 
Viewing Stands /  / Barbecue / 
Inflatables (e.g. Bouncy Castle) /  / Bonfire / 
Portable Staging /  / Boat/Canoe / 
P.A. System /  / Market Stalls / 
Stewarding/Security /  / Re-enactment Groups / 
On Site Communications /  / Agricultural Activities e.g.
ploughing / 
Water / 
Other (please specify / 

Insurance

27.Has Insurance been arranged in respect of Public Liability / Yes /  / No / 
28.What is the name of the insurer?
29.What is the value of Cover? / £
(Recommended that this should not be less than £10 million)
Signed :
Position in Organisation:
Date:
Please send this completed form, together with any supporting documentation either by e-mail to: or by post to:
Chairperson
Safety Advisory Group
Lisburn & Castlereagh City Council
Civic Headquarters
Lagan Valley Island
Lisburn BT27 4RL
PLEASE NOTE:Copies of this form will be forwarded to members of the Lisburn & Castlereagh City Council Safety Advisory Group – this includes all of the Emergency Services and relevant local authority services.
All event organisers are requested to complete a Debrief & Evaluation Form following their event in order to ensure that any concerns are addressed for future events and ensure the success of events in the Lisburn & CastlereaghCity Council area. This will be sent via email or you can download the document at:

Should you have any queries regarding this notification form, please contact the Environmental Health Service Unit at the above email address.
Data Protection Act 1998
Lisburn & Castlereagh City Council collects the Data on this form for the purposes of the Management and Application of the LG (MP) (NI) Order 1985. This data may be passed to other relevant Government agencies.

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