TUSA Forms Application for a Temporary Stall on a University Campus TUSA 002 Step 1 - Contact detailsName of stall organiser*Position title*Name of TUSA Club, Society, SRC PortfolioMobile Number*Email* Step 2 - Details of proposed stallDate of proposed stall*Please write like this format example. 4th April 2017Start Time* : HH MM Finish Time* : HH MM Type of stall*e.g. cake stall, sausage sizzle, information exchangePreferred location of stall*Will you be erecting scaffolding, stage, lighting or any other external structure?* Yes No If a structure is being erected, please describeIf yes, will you require access to onsite mains power?* Yes No Step 3 - Endorsement from TUSA / club / society/ campus PresidentName of TUSA club/ society/ campus president* First Last This application has been endorsed by TUSA club/ society/ campus presidentStep 4 - Checklist and declaration by applicantNote: Please tick the relevant boxes below and sign to indicate that you have read and agreed to the terms.If liquor is to be served, I have completed a University of Tasmania Liquor Permit Application, and if the liquor is to be sold and/or an entry fee charged and alcohol served, I have attached a copy of appropriate permit from the Tasmania Commissioner for Licensing.* N/A Yes Permit Pending and will be forwarded upon receipt If food is to be sold and/or supplied, I have obtained the appropriate permits/ licences from the city council (North / Northwest Tas) or the TUSA (South Tas)* N/A City Council Permit - attached TUSA (HCC) Food Permit - attached Permit pending and will be forwarded upon receipt Party Safe Registration* Yes N/A (Not a large event) Have you registered your event with Tasmania Police? This is purely for health and safety purposes so Emergency Services know what to expect in the case of Emergency. You can register your event at www.police.tas.gov.au/services-online/party-safe/Upload your permits Drop files here or As a TUSA affiliated club/ society/ council, I have public liability cover In this Form of Indemnity, the University of Tasmania is ‘the Owner’. The area owned by the Owner and situated on campus is the stall site. A person 18 years or older who receives approval for temporary occupation of the stall site from the University is ‘the Occupier’. The Occupier must be present throughout the period of occupation of the stall site. By lodging this application, the Occupier warrants that he or she is duly authorised by the organisation named above and accepts full responsibility for each person occupying the stall site during the approved period of occupation. The Occupier agrees to ensure compliance by participants with all applicable laws and University By-laws. The Occupier agrees to indemnify the Owner and its servants, officers and agents against any liability whatsoever to any person, firm, body, instrumentality or company in respect of any claim, demand, dispute or proceedings of whatever nature for loss or damage including personal injury or death, resulting from or arising out of or as a consequence of the Occupier’s occupation of the stall site, or occurring while the Occupier is in occupation of the stall site, and caused by any cause whatsoever including the negligence of the Owner.I agree to the aboveName* First Last Date* Date Format: MM slash DD slash YYYY Campus Services Use OnlyApproved Yes No Signature
