Event Health Services Booking Enquiry
Event Time and Location
Event name
Event Site
Please enter the address for the location of your event
Venue name
Venue Address Line 1
Venue Address Line 2
Venue Suburb
Venue Postcode
Venue State
Event date
Coverage start date(dd/mm/yyyy)
Coverage start Time(hh:mm)
Coverage StartDateTime (Calculated)
Hidden Count
Coverage EndDateTime (Calculated)
Coverage end date(dd/mm/yyyy)
Coverage end time(hh:mm 24hr)
Click
"Add Another Date / Time"
to add additional event dates:--
Total Events
Site Contact Information
Who is the site contact for the event?
Name
Mobile Phone
Email
Event Information
Type of event
Please select...
Festival/ Concert
Motorsport Event
Equestrian Event
Ceremonial
Cycling/ BMX/Mountain Biking
School Event/Sports
Community Sports
Professional Sports
Fete/Fair/Community Day
Fun Run/Marathon/Walk
Parade/Pageant
Expo/Display
Country Show
Other
Event setting
Please select...
Indoor
Outdoor
Both
Please describe your event
Name of the Governing Body
Is this a ticketed event?
Yes
No
Will alcohol be consumed at the event?
Yes
No
Is St John required to cover the participants/performers?
Yes
No
Professional or amateur participants
Please select...
Professional
Amateur
Both
Is St John required to cover the spectators?
Yes
No
Is this a fundraising event for a registered charity?
Yes
No
What Charity?
What funds will the charity get?
Attachments
If you have the information please attach any documentation relevant to your event.
Some Examples:
- Site Maps
- Governing Regulations
- Risk Assessments
- WHS Documentation
Attach Documents
Yes
No
Attach any relevant documents (Office files or images only)
Country Show Event Details
We will risk assess and quote against generic industry medical regulations and specifications unless you provide your own regulations and risk assessments
Which of the below activities will occur and require St John coverage?
Country Events
Please select...
Motorsport
Equestrian Events
Cycling / BMX / Mountain Biking
Other
Woodchop
Cattle shows
Rodeo
Other Event Activities
Please provide a schedule for all activities
Has your insurer provided guidelines surrounding first aid services for the event?
Yes
No
If not already attached please specify their requirements
Does your Organising Committee have specific requirements or requests of St John?
Yes
No
If not already attached please specify their requirements
Motorsport Event details
We will risk assess and quote against generic industry medical regulations and specifications unless you provide your own regulations and risk assessments
Motorsport type
Please select...
Dirt Karts (as per AIDKA)
Karting (track racing as per Australian Karting Association)
Motorcycling (as per Motorcycling SA)
Motor Racing Off Road (CAMS)
Motor Racing – Rally / Rally sprint (CAMS)
Speedway (Speedway Australia)
Motorcycling
Please select...
Road Racing
Speedway
Freestyle Motorcross
Supercross
Enduro
Supermoto
Dirt Track
Reliability Trials
Minikhana
Minikhana Type
Please select...
Practice Days
Club/Inter-club events
State Championships
Motor Racing Off Road
Please select...
Club Event
State Events
National Events
Is St John mandated to have a Patient Transport Vehicle on site for your event?
Yes
No
Please list your industry regulations or specifications below
Alternatively provide a link to Regulations or Specifications
or upload a copy
Equestrian Event Details
We will risk assess and quote against generic industry medical regulations and specifications unless you provide your own regulations and risk assessments
Which type of equestrian events will occur?
Please select...
Campdraft (Australian Campdraft Association)
Dressage
Eventing (including cross country and jumping tests)
Show jumping
Rally
Clinic
Mounted Games
Show Riding
Gymkhana
Rodeo (Australian Professional Rodeo Association)
Campdraft
Please select...
1-3 day event <50 competitors
1-3 day event >50 competitors
Event outside of proximity of ambulance services and hospitals
Competition?
Yes
No
Number of Riders
Please select...
Less than 50 riders
51 – 199 riders
More than 200 riders
Cross Country over 60 cm?
Yes
No
Please list your industry regulations or specifications below
Alternatively provide a link to Regulations or Specifications
or upload a copy
Has your insurer provided guidelines surrounding first aid services for the event?
Yes
No
If not already attached please specify their requirements
Cycling/BMX/Mountain Biking Event Details
We will risk assess and quote against generic industry medical regulations and specifications unless you provide your own regulations and risk assessments
Event type
Please select...
Cycling
BMX (BMX Australia)
Mountain Bike (Mountain Bike Australia)
BMX
Please select...
General Club Meet
State Event
National Event
Mountain Biking
Please select...
Club race - Cross Country and Downhill 2-8 hours circuit
Club race - Cross Country and Downhill >8hour and >80km race
Races over 100km
National Races
What is the distance of the ride? (In KM's)
Please upload a copy of the route
Has your insurer provided guidelines surrounding first aid services for the event?
Yes
No
If not already attached please specify their requirements
Walk/Run Event Details
We will risk assess and quote against generic industry medical regulations and specifications unless you provide your own regulations and risk assessments
What is the distance of the walk/run? (In KM's)
Upload a copy of the route
Has your insurer provided guidelines surrounding first aid services for the event?
Yes
No
If not already attached please specify their requirements
What is provided onsite
How many first aid posts/refreshment stops do you require St John to cover?
Please select...
1
2
3
4
5+
Are you able to provide a First aid treatment room or canopy with sides?
Yes
No
Is there access to lighting?
Yes
No
Is 240v power available?
Yes
No
Running Water?
Yes
No
Is ice available for patient treatment?
Yes
No
Will refreshments/meals be provided for St John members?
Yes
No
Is parking available?
Yes
No
Do you require St John to follow the event, and provide a tail end vehicle?
Yes
No
Where will St John need to set up?
Any other facility information (not listed above)
Attendees
Spectator Information
Demographic of spectators
Please select...
Under 18
18+
Mixture
Maximum number of spectators at any time
Total spectators expected over length of event
Participant Information
Demographic of participants or performers
Please select...
Under 18
18+
Mixture
Number of participants/performers expected
Event Organiser
Who is organising the event
Organiser Contact
Name
Phone Number
Email Address
Organisation
Organisation Name
Organisation Address Line 1
Organisation Address Line 2
Organisation Suburb / Town
Organisation Postcode
Organisation State
Billing details Same as Organiser Details?
Please select...
Use above details
Enter different details
Billing details
Billing Contact
Billing Contact name
Billing Contact number
Billing Contact Email
Bill to
Organisation name
Billing Address Line 1
Billing Address Line 2
Billing Suburb
Billing Postcode
Billing State
Billing Email