ST JOHN AMBULANCE QUEENSLAND
EVENT REQUEST FORM
To be completed by client and returned to Health and Medical Services Team.
Email:
enquiries@stjohnqld.com.au
Contact Details
Company/Organisation
ABN
Contact Name
Contact Phone
Mobile Number
Billing Address
Contact Email
(for booking)
Event Details
Event Name
Date/s of Events
Venue Name
Event Location/Street Address
Event Start Time
St John staff will arrive 30 minutes prior for operational setup
Event End Time
St John staff will depart 30 minutes after to allow for pack down
Number of People
(expecting to attend)
Type of Activities
Amusements & Vendors
Jumping Castle
Rides
Animals Onsite
Food Trucks/Vendors
Water Activities
Face Painting
Other
Brief description of your event:
Site Details
Number of first aid fixed locations required
Are first aid locations indoor, outdoor, or a combination?
Indoor
Outdoor
Combination
Approximate size of designated first aid area?
Will a marquee be provided for outdoor first aid location/s?
Yes
No
Is power available to each first aid location?
Yes
No
Is there lighting to each first aid location?
Yes
No
Is food available onsite?
Yes
No
Will a table and chairs be provided to each first aid location?
Yes
No
Identified Risks
Is there a risk plan in place for the event?
Yes
No
Age of those taking part in the event
Under 18
18+
Over 65
Family Groups
Is alcohol allowed on site?
(BYO or for purchase)
Yes
No
Are other agencies or services on site?
Police
Ambulance
Fire Brigade
Security
Other
Further information, comments or questions:
Access and Egress
Is there vehicle access?
(to the set-up site)
Yes
No
Can the vehicle remain with the crew?
Yes
No
Is there Parking Onsite?
Yes
No
Is parking free of charge?
Yes
No
Has clear access for Queensland Ambulance Service vehicles been provided?
Yes
No
Contact Information