CONSERVATION AND LAND MANAGEMENT ACT (PART 9)

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Commercial filming and/or photography application

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This application applies to persons or organisations intending to undertake commercial filming or photography activities on reserves managed by the Department of Parks and Wildlife (DPaW).

APPLICATION PROCESS

To assist DPaW in the proper assessment of commercial film applications and to approve lawful authorities in reasonable time, DPaW requests that all proposals be submitted at least six weeks before the expected film dates. However, shorter timeframes may be possible, if approved by DPaW.DPaW will endeavour to process all applications submitted, in time, however, should this not be possible, it is advisable that you have a backup plan either with other locations or different dates.

Submit all pages of this application to: Licensing Officer, Policy and Tourism Branch

Telephone: (08) 9334 0119 (International Code: + 61 8 9334 0119)

Email:

Post:Locked Bag 104, Bentley Delivery Centre WA 6983

Your application will be forwarded to the DPaW office responsible for assessment and consideration of any local requirements.

Please attach any supporting documentation to this form (e.g. scripts, production schedules, insurance information) to assist DPaW to assess your application.

APPLICANT DETAILS

NAME OF APPLICANT:(Person/Company/Incorporated Body only)

Note: The application must be made by one person or company proposing to undertake the activity (activities) for which permission is sought. The application cannot be made using a trading/business name.

If the application is by a company please provide the Australian Company Number (ACN)

Name and address of directors

and secretaries

Name of copyright owner

ALL APPLICANTS:please provide the Australian Business Number (ABN)

TRADING/BUSINESS NAME:

Is/are the name(s) registered? Yes No

If yes, please provide the registered name(s)

and the registration number(s)

POSTAL ADDRESS

OF APPLICANT:

Note: If the applicant is a company please provide the postal address of the contact person

Name of contact

Email Website

Phone 1 Phone 2 Fax

Emergency contact name/phone number:

(If different to above contact person)

DETAILS OF ACTIVITY

Period of proposed filming/

photography:

Commencement DateCompletion Date

Title of film/name of

program/name of product:

Name any previous DPaW contact person(s):

Motion film Still photography

Type of film to be undertaken: (tick as appropriate)

Education
Feature film
Documentary / Advertising
Tourism/
Recreation / Other(please specify):

Purpose of still or motion film:(tick as appropriate)

Yes No
Other/partial(please specify):

Does the film have Tourism WA sponsorship?

Sell on to a third party e.g. Image library, publisher, broadcaster (please specify third party and use)
Editorial (please specify)
Advertising or promotion of a product or service (e.g. Tours, conference, brochures)(pleasespecify)
Other use(please specify)

How will the still or motion film be used or shown?(tick and specify as appropriate)

Description of the production: (Detailed explanation of the production. Please include story boards or any other supporting documents).

ACCESS REQUIREMENTS

Please list which parks (terrestrial and/or marine) you wish to access. If accessing multiple areas of Western Australia, please list all parks. Please also attach a detailed itinerary and maps which details specific locations and roads/tracks/trails to be used.

Park or Reserve***
(terrestrial and/or marine) / Features of interest***
(Specify which sites, locations, routes, tracks and camping sites you intend to access within the reserve/park) / Access Date

*** If you require more space please use the comments sections of the form.

Yes No

Do you intend to access the Munda Biddi Trail or Bibbulmun Track?

Yes No
If Yes, Please give more detail (when/where/how long):

Do you intend to conduct any off-road/track driving/walking?

For examplefor vantage points or to access areas in the parks listed above?

Yes No
If Yes, Please give more detail:

Do you require roads or car parks

to be closed during filming?

Number of people in filming party:

Yes No
If Yes, where:

Do you intend to camp on CALM Land?

Yes No
If Yes, in what capacity:

Will you need assistance from DPaW staff? Supervision fees may apply

Yes No
If Yes, in what capacity and for how long:

Will you need DPaW staff to film? Supervision fees may apply.

Yes No
If yes, please describe how you propose to depict Aboriginal people or items/areas of cultural significance:

Will you be featuring Aboriginal people or items/areas of cultural significance?You may be required to consult with or receive written approval. Contact DPaW as soon as possible, for further information.

VEHICLES AND EQUIPMENT

Vehicles:

Hired from another organisation or business

Owned by this business/organisation (please complete the table below)

Note: If you are contracting someone to provide transport to and from location you must ensure that they have a current DPaW commercial operations licence. Please provide their DPaW licence number if possible.

Vehicle Type
(4WD, minibus, coach, aircraft etc) / Registration No. / Registration Expiry / Transport Licence no.
(for vehicles not registered in Western Australia)

Vessels:

Vessel Type(s)
(canoe, kayak, dinghy, charter vessel etc) / SPV no./ reg. No. / size of vessel (m)

Number and type of cameras

to be used:

Will any structures or facilities be erected or does the area require any alteration to occur to allow the filming? Please detail:

Other equipment: (Please list any other equipment that may be used during this operations, for example, motors, generators/lights, dolly tracks, shade shelters, vehicles, portable toilets, firearms/weapons, animal traps/snares or bait, cooking equipment.)

Note: Firearms, snare, traps and bait are not to be carried on CALM land unless a licence is obtained. Licences are issued only for scientific purposes.

SAFETY

What steps have been taken to ensure the well being of others in your party: (Please list, for example, first aid kit, fire extinguisher, life jackets, HF radio, etc. and any other emergency response plans.)

PAYMENT OF FEES AND CHARGES

Depending on the filming operation, fees and charges may apply.

Fees and charges may be paid via the following means: Invoice, cheque or credit card and in person (you will be advised of locations you can pay).

Yes No If Yes, for how many people*:

Do you request that park entry fees be waived?

Yes No If Yes, for how many people*:

Do you request that camping fees be waived?

Please ensure that you have a copy of the licence or lawful authority if issued. Camping fees may still apply.

INSURANCE

Applicants are reminded that public liability insurance is required to be submitted along with this application. This should be to the value of no less than $10 million per event

CHECKLIST

Yes / N/A
Have you completed all sections of the application form, including the deed poll section below?
Have you included detailed information pertaining to the planned filming operation including specific locations and how you plan to conduct the filming on site?
Have you included details of the vehicles you plan to use for the operation and/or survey certificates and provided registration and/or vessel SPV numbers?
Have you included a copy of your public liability insurance policy with $10,000,000 coverage, covering all proposed activities and locations and made your insurer aware of the conditions and indemnity?
Have you signed the application and had it witnessed?
If your application has been submitted within six weeks of your planned dates, do you have an alternative location or set of dates should the application not be approved in time?

DEED/POLL

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