Page 1 of 3 Maritime Event Application Form

Maritime Event Application Form

Important

Email completed applications to the harbourmaster@aucklandcouncil.govt.nz 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

harbourmaster@aucklandcouncil.govt.nz or telephone 09 362 0397.