Section 7 of 8 SPECIAL SAFETY CERTIFICATE Event or activity for which the special safety 7.1 certificate is required (e.g. pop concert, display, festival, other non-specified activity, etc.) Please give the date(s) of the proposed event with start and finish times (see below for adding another event) Date of the event: From: To: 7.2 7.3 Time of spectator admission From: To: Maximum number of seated spectators 7.4 Maximum number of standing spectators 7.5 Details and location of any staging for the event 7.6 7.7 In the case of a regulated stand, do you propose to make any changes or Yes / No If yes, go to 7.8 adaptations to the spectator accommodation or to arrangements for entry and control of spectators for this event? If no go to 7.9 7.8 Please provide details SIMILAR EVENTS OVER THE LAST THREE YEARS How many times has this event taken place at the sports 7.9 ground / in another location during the last three years? Please provide the following details about each such event over the last three years Year(s) 7.10 Name of event / occasion 7.11 Date(s) on held 7.12 Number of spectators attending 7.13 Number of staff / employees / artists involved 7.14 Add another event? Yes / No If yes, attach details on a separate sheet Now go to 8.1 Section 8 of 8 ADDITIONAL DETAILS 8.1 Please attach any additional information which is Documents attached: required or relevant to your application (management policies, risk assessments, insurance, site plan, etc.) DECLARATION 8.2 I (print name) declare that I am duly authorised on behalf of the above named ……………………………………… sports ground / club to make application for the said safety certificate. Signed: Dated: Position at club / promoter: To be completed by the authorised officer on behalf of the enforcing authority Determination Determination date Determination reason DCMS contacted? 8.3 Designated / Regulated / n/a 8.4 Date application received date of application processing Issue date of certificate Authorisation 8.5 Signed by (Group Manager) Name of authorised officer dealing Job title of authorising officer
Section 7 of 8 SPECIAL SAFETY CERTIFICATE 7.1 Event or activity for which the special safety certificate is required (e.g. pop concert, display, festival, other non-specified activity, etc.) Please give the date(s) of the proposed event with start and finish times (see below for adding another event) 7.2 Date of the event: From: To: 7.3 Time of spectator admission From: To: 7.4 Maximum number of seated spectators 7.5 Maximum number of standing spectators 7.6 Details and location of any staging for the event 7.7 In the case of a regulated stand, do you propose to make any changes or adaptations to the spectator accommodation or to arrangements for entry and control of spectators for this event? Yes / No If yes, go to 7.8 If no go to 7.9 7.8 Please provide details SIMILAR EVENTS OVER THE LAST THREE YEARS 7.9 How many times has this event taken place at the sports ground / in another location during the last three years? Please provide the following details about each such event over the last three years 7.10 Year(s) 7.11 Name of event / occasion 7.12 Date(s) on held 7.13 Number of spectators attending 7.14 Number of staff / employees / artists involved Add another event? Yes / No If yes, attach details on a separate sheet Now go to 8.1 Section 8 of 8 ADDITIONAL DETAILS 8.1 Please attach any additional information which is required or relevant to your application (management policies, risk assessments, insurance, site plan, etc.) Documents attached: 8.2 DECLARATION I ……………………………………… (print name) declare that I am duly authorised on behalf of the above named sports ground / club to make application for the said safety certificate. Signed: Dated: Position at club / promoter: To be completed by the authorised officer on behalf of the enforcing authority Determination Determination date Determination reason DCMS contacted? 8.3 Designated / Regulated / n/a 8.4 Date application received date of application processing Issue date of certificate Authorisation 8.5 Signed by (Group Manager) Name of authorised officer dealing Job title of authorising officer
safety-certificate-application-form.docx