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Please complete the questions on this form in order for us to risk assess your event and ensure you are getting the correct cover
Name
Phone
Email
Name of Event
Address of Event
Nature of Event
Classical Performance
Public Exhibition
Pop or Rock Concert
Dance Event
Agricutural or County Show
Marine and Water Sports
Motorcycle display
Aviation
Motor Sport
Sporting Events
Target Shooting Event
Demo/Marches Low Risk of Disorder
Demo/Marches Medium Risk of Disorder
Demo/Marches High Risk of Disorder
Demo/Marches Opposing Fractions Involved
Start date of event
Start time of event
Finish time of event
Finish date of event
Type of Venue
Indoor
Stadium
Outdoor Confined i.e Park
Other Outdoor i.e Festival
Widespread public location in streets
Temporary Outdoor Structure
Includes Overnight Camping
Standing or Seating
Seated
Mixed
Standing
Audience Profile
Full mix in family groups
Full mix not in family groups
Mainly young adults
Mainly children and teenagers
Mainly Elderly
Full mix rival factions
Past Casualty Figures
Low Casualty Rating (<1%)
Medium Casualty Rating (1-2%)
High Casualty Rating (>2%)
First Event
No Data
Expected Numbers
<1000
<3000
<5000
<10000
<20000
<30000
<40000
<60000
<80000
<100000
<200000
<300000
Expected Queueing
Less than 4 hours
More than 4 hours
More than 12 hours
Time Of Year
Summer
Autumn
Winter
Spring
Nearest A&E
Less than 30 mins by road
More than 30 mins by road
Type of A&E
Choice of A&E
1 x Large A&E Department
1 x Small A&E Department/Minor injuries
Additional Hazard
Carnival
Helicopters
Motorsport Display
Parachute Display
Street Theatre
Facilities provided for staff
Food
Drink
Toilets
Shower
Treatment room/Marquee
Please provide details of the facilities provided
Please attach your event plan
Upload file
Please attach site Map
Upload file
Please attach copies of risk assessments
Upload file
Any general comments
Thank you for contacting us.
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Star Medical Services Limited, EBB Stadium, High Street, Aldershot, Hampshire, GU11 1TW
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01483385911
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