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Name of Applicant
Name of Organisation
Office Held by Applicant
Address of Organisation
Details of Event
Nature of Event
Name and Address of Sports Governing Body (if applicable)
Date of Approval by Governing Body for this Event
Name and Address of Insurers for this Event
No. of Participating Vessels
No. of Safety Boats Arranged
Details of First Aid Provision
I/we on behalf of the above organisation hereby apply for the approval of the Department for Social Development to the above event.
I/we undertake that third party liability insurance will be arranged for the event in a sum adequate for the event but not less than £1 million sterling.
I/we further undertake to furnish to the Department for Social Development proof of such insurance not less than 72 hours prior to the commencement of the event.
I/we hereby indemnify the Department for Social Development against all liabilities arising from the event including death, personal injury, loss of or damage to property and necessary withdrawal of permission from the Department for the use of the river for the event.
Signature(s) of Applicant(s)
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