Cape Byron State Conservation Area, Application Form

Cape Byron State Conservation Area
Application Form – Wedding Ceremony
Applicants Details
applicant name/s:
address:
p/code:
phone:
mobile:
contact name:
email:
Wedding Ceremony Details
*Bookings are to be made in NSW time, please consider this during daylight saving period.
date of wedding:
location of wedding:
setup time (max ½ hour prior to guests arrival):
total no. of participants:
guests arrival time:
number of vehicles:
ceremony start to finish time:
to
other transport arrangements: (e.g. coach, minibus)
Special Conditions
Are any special arrangements proposed? (e.g. ceremony outside of standard hours; musicians being used)
No
Yes ( please specify)
I acknowledge and agree to abide by the conditions of the Consent and any ‘Special Conditions’ which may be advised:
Applicant Signature: ………………………………..…... Date: ………………………………
*Application Checklist - Prior to submitting this application please ensure the following:
Contact our office to check date & location availability.
Complete Application Form, including tick box section on following page.
Include payment (see fee schedule on Information Sheet for relevant fee/s).
Include signed Wedding Ceremony Consent.
If wedding photography is to be taken at another location on the Reserve, check availability & include
separate Wedding Photography Application Form & fee.
Please tick the box. Provide further details if you tick ‘yes’ to any of the questions.
~ Will the proposed event have any impacts outside the park, eg. traffic, noise or parking?
No
Yes (specify) _______________________________________________________________
~ Are any special security arrangements proposed?
No
Yes (specify) _______________________________________________________________
~ Will any special parking arrangements be required in the park?
No
Yes (specify) _______________________________________________________________
~ Will vessels, aeroplanes or helicopters be used?
No
Yes (specify) _______________________________________________________________
~ Will animals including horses, dogs or cats be brought into the park?
No
Yes (specify) _______________________________________________________________
~ Will there be any earthworks or other environmental modification required?
No
Yes (specify) _______________________________________________________________
~ Will any signs, including posters or other advertising material, be erected?
No
Yes (specify) _______________________________________________________________
~ Will any disturbance to animals or their habitats, including breeding sites, be caused?
No
Yes (specify) _______________________________________________________________
~ Will any fires be lit other than in public fire places or flammable substances be brought into
the reserve?
No
Yes (specify) _______________________________________________________________
~ Will there be any structures erected or plant and equipment brought in the park?
No
Yes (specify) _______________________________________________________________
~ Will there be any clearing of vegetation required?
No
Yes (specify) _______________________________________________________________
~ Will any weapons, including spearguns, firearms, explosives, fireworks be brought into the
park?
No
Yes (specify) _______________________________________________________________
~ Will any dangerous activities such as abseiling, base jumping , bungy jumping, rock
climbing, parachuting or hang gliding be undertaken in the park?
No
Yes (specify) _______________________________________________________________
Last Updated – June 2011
Please forward the completed application & consent forms together with payment to:
Cape Byron Trust / National Parks Parks & Wildlife
Byron Coast Area Office
PO Box 127, Byron Bay NSW 2481
Ph (02) 66209 300 Fx (02) 66209 333
[email protected]
Check Attachments
Wedding Ceremony Application
Application Fee
Supervision Fee (if applicable)
Signed Consent
Payment Details
Enclosed is a Cheque/Money Order for $
OR please debit my :
Mastercard
.
Visa
Card Number
(Cheques made payable to NPWS/Cape Byron Trust)
$
.
Expiry Date
/
Name of Cardholder __________________________________________
Signature of Cardholder __________________________________________
Office Use Only
Application received by: .................................................................... on:…………………………………………..
Application approved without amendment
Application approved subject to attached special conditions signed by Authorising Officer
Application not approved (reasons attached/applicant notified)
Total fees:
Application fee
$ …………
Supervision fee @ $71.50 per X ........ hours (if applicable)
$ ..............
Additional charges (eg. parking fees)
$ ..............
Total fees
$...............
Fee due: $ ................. Fees received on: ..............................……………. Receipt no.: .....................................
Fees paid by:
Cheque
Money Order
Eftpos
Cash
Authorising Officer Signature: ………………………………………… Date: ………………………………………
Position: …………………………………………………………………………