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Filming in Baw Baw Application Form

Applicant Contact Details

Company/applicant name (responsible for filming): * (required)

Does the company name match the name insured on the public liability insurance? * (required)

Yes

If No, please provide more information:

Note: approval will not be issued without current public liability insurance

Contact name: * (required)

Position/title: * (required)

Contact phone: * (required)

Contact email: * (required)

On-site contact name: * (required)

On-site contact position/title: * (required)

On-site contact phone: * (required)

On-site contact email: * (required)

Project Details

Project name: * (required)

Project type: * (required)

If Other, please specify:

Proposed filming date start: * (required)Proposed filming date start: * (required)

Open the calendar popup.

Proposed filming date end: * (required)Proposed filming date end: * (required)

Open the calendar popup.

Alternative filming date start (weather hold/contingency planning): * (required)Alternative filming date start (weather hold/contingency planning): * (required)

Open the calendar popup.

Alternative filming date end (weather hold/contingency planning): * (required)Alternative filming date end (weather hold/contingency planning): * (required)

Open the calendar popup.

Filming times (including bump-in and bump-out times): * (required)

Exact location/s of the proposed filming (including any privately owned land): * (required)

Please provide a brief summary of the scene and/or activities: * (required)

Number of people on location: * (required)

Number of cast: * (required)

Number crew: * (required)

Number of car parking spaces required at filming location: * (required)

Number of cars: * (required)

Number of trucks: * (required)

Number of oversize vehicles (over 7.5m or over 4.5 tonnes): * (required)

Will the production need a unit base?

Yes

Exact location/s of proposed unit base (including any privately owned land):

Unit base times (start/finish):

Number of parking spaces required at unit base:

Number of cars at unit base:

Number of trucks at unit base:

Will the production erect any temporary structures such as tents/marquees at the unit base? * (required)

Yes

If Yes, please provide details (number, size, style):

Will the production require traffic management or pedestrian management?

Note: If production is disrupting traffic or pedestrian flow a Traffic Management Plan (TMP) or Pedestrian Management Plan (PMP) incorporating a Risk Management Plan will be required.

* (required)

Yes

If Yes, type of activity (e.g. hold and release, road closure):

Name and details of the traffic/safety company supplying the TMP or PMP:

What times will the roads be affected (start/finish)?

Name/s of road/s affected by closure/traffic hold:

Details of large equipment the production will bring to the location (e.g. camera cranes, scaffolding, lighting towers or N/A): * (required)

Does the production involve any of the following?

Note: Those marked with an asterisk * require confirmation of approval from Victoria Police or other state government agencies, to be attached to this application.

firearms/weapons (incl imitation)*

amplified music/sound

stunts*

other safety concerns*

may have environmental impact

may cause offence or concern to the public

Provide details of activity:

Will the proposed filming represent the actual location? * (required)

Yes

If No, please identify the location the filming will represent:

Attachments (Maximum document size of 1MB)

Note: If you experience an error when attempting to submit this form you will need to re-attach all relevant documents before proceeding.

Essential Documents

Public Liability Insurance (current Certificate of Currency with at least $20M cover): * (required)

Site plan/mud maps: * (required)

Risk Management Plan: * (required)

Optional Documents

Traffic Management Plan:

Pedestrian Management Plan:

Running sheet/schedule:

Stakeholder Communication Plan (Resident Notification Letter):

Other permits, approvals or information:

Other permits, approvals or information (2):

Other permits, approvals or information (3):

We agree to abide by the Victorian Screen Industry Code of Conduct (mandatory) * (required)

Yes

Type the characters you see in the image below * (Required)

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Privacy Statement

The information collected on this form is required by Council to ensure measures are in place for events management and filming activities within Baw Baw Shire. Council may need to notify various parties (e.g. authorities and emergency services) of upcoming events and may disclose this information to these parties. If this information is not collected, the application cannot be processed. Contact the Privacy Officer on 5624 2411 for questions.