National Health Act, 2003 (Act No. 61 of 2003)RegulationsEmergency Care at Mass Gathering Events Regulations, 2017AnnexuresAnnexure A : Application for Approval of an Event |
ANNEXURE A
APPLICATION FOR APPROVAL OF AN EVENT
To: The Provincial EMS Manager: ________________________________________________________
Province: ____________________________________________________________________________
Email: _______________________________________________________________________________
Facsimile: ____________________________________________________________________________
Dear Sir /Madam
Please find set out below an application in terms of regulation 9 of the Emergency Care at Mass Gathering Events Regulations, 2017.
SECTION 1 - EVENT DETAILS
1.1 | Name of Event: _____________________________________________________________ |
1.2 | Nature of Event:_____________________________________________________________ |
1.3 | Event Venue:_______________________________________________________________ |
1.4 | Local Authority certified safe spectator/participant capacity of the Venue: |
____________________________________________________________________________
1.5 | Physical Address of Event Venue: |
____________________________________________________________________________
1.6 | GPS Co-ordinates of Event Venue: _____________________________________________ |
1.7 | Day & Dates of Event: _________________________________________________________ |
1.8 | Scheduled Commencement Time of Event: _____________________________________ |
1.9 | Anticipated Duration of Event (spectator/participant access time to closure of venue): |
1.10 | Nearest SAPS Police Station: __________________________________________________ |
SECTION 2 - RESPONSIBLE PERSONS
2.1 | Event Organizer: |
2.1.1 | Contact Details: |
• | Contact Person: |
• | e -Mail:_________________________________________________________________ |
• | Mobile No.: ____________________Telephone No. (Office):____________________ |
• | Postal Address : |
• | Physical Address: |
2.2 | Stadium Venue Owner: |
2.2.1 | Contact Details: |
• | Contact Person:_____________________________________________________________ |
• | e -Mail: |
• | Mobile No.: _______________________Telephone No. (Office):____________________ |
• | Postal Address:_____________________________________________________________ |
• | Physical Address:___________________________________________________________ |
SECTION 3 - CONFIRMATION
I/We, the undersigned, confirm that:
3.1 | I/We have/have not previously submitted an APPLICATION FOR THE APPROVAL OF AN EVENT in terms of the EMERGENCY CARE AT MASS GATHERING EVENTS REGULATIONS; |
3.2 | I/We have submitted a risk categorisation to the South African Police Service and have received a low/medium/high risk categorisation in respect of our application in accordance with the Safety at Sports and Recreational Events Act, 2010 (Act No 2 of 2010). (Proof of Risk Categorisation from the SA Police Service must be attached); |
3.3 | There is a valid and current licensed Events Medical Service provider who is contracted to provide the health and medical services. (Provide proof of licensing as per the Emergency Medical Services Regulations must be attached); |
3.4 | I/We have developed the emergency medical services plans for the event. |
________________________________________________
For and on behalf & duly authorised by
(INSERT FULL LEGAL NAME OF EVENT ORGANISER HERE)
SECTION 4 - ACKNOWLEDGMENT OF RECEIPT OF APPLICATION FOR THE APPROVAL OF A MASS GATHERING EVENT
TEMPLATE GUIDE
Office of the Provincial EMS Manager
Address
To:
Name of Event Organiser:
Address:
Event:
Dear
1. | I, the undersigned Provincial Emergency Medical Services Manager, hereby acknowledges receipt of your application received on the _________________for the approval of provision of Emergency Care at a Mass Gathering Event. |
2. | The application will be processed in accordance with the Emergency Care at Mass Gathering Events Regulations, 2017 |
3. | The outcome of your application will be communicated to you within 10 workings days. |
________________________________________________
For and on behalf & duly authorised by
(INSERT FULL LEGAL NAME OF THE PROVINCIAL EMERGENCY MEDICAL SERVICES MANAGER HERE)
SECTION 5 - OUTCOME LETTER FOR THE APPROVAL OF EMERGENCY CARE AT A MASS GATHERING EVENT
TEMPLATE GUIDE
Office of the Provincial EMS Manager
Address
To:
Name of Event Organiser:
Address:
Event:
Dear
1. | You are hereby advised that your application for the abovementioned event has been: |
Approved |
Approved subject to the following conditions: |
||
Refused |
||
You may appeal this decision to the Head of Department, in accordance with the Emergency Care at Mass Gathering Events Regulations, subsection 13(1).
The reasons for refusal are as follows: |
||
______________________________________________
For and on behalf & duly authorised by
(INSERT FULL LEGAL NAME OF THE PROVINCIAL EMERGENCY MEDICAL SERVICES MANAGER HERE)
SECTION 6 - CONFIRMATORY CHECKLIST FOR THE PROVINCIAL EMERGENCY MEDICAL SERVICES MANAGER
Name of Event: _______________________________________________________________________
Nature of Event: ______________________________________________________________________
Event Venue: _________________________________________________________________________
Physical Address of Event Venue: _______________________________________________________
I, the undersigned Provincial Emergency Medical Services Manager, hereby confirms that an inspection/evaluation was undertaken of the above-named event as follows:
1. |
The event is being held in a venue that meets the requirements for a high risk event grading certificate in terms of section 8(4) of the Safety at Sports and Recreational Events Act, 2010 |
||
Yes |
No |
||
2. |
The Event Medical Services provider does have historical experience in the holding of similar events of a similar size; |
||
Yes |
No |
||
3. |
The Event Medical Services provider has sufficient human and medical equipment resources to cater for the number of spectators/participants at this event; |
||
Yes |
No |
||
4. |
The expected spectators/participants attendance, based on the attendance at historical events of a similar profile, is; |
||
5. |
That inclement weather is/is not (n/a) forecasted for the event. The long range weather forecast indicates the following weather conditions on the day of the event; |
||
6. |
There will be controlled sale of alcohol to the general public at the venue in compliance of existing protocols with the local SAPS; |
||
Yes |
No |
||
7. |
A licensed Event Medical Service provider will provide a comprehensive health and medical services for this event; |
||
Yes |
No |
||
8. |
There are material historical medical incident trends at similar events hosted previously at the venue which could have an impact on the safety of spectators/participants at the event; |
||
Yes |
No |
||
9. |
There will be marketing/free merchandise/meals to spectators/participants during the event; |
||
Yes |
No |
||
10. |
That the age or profile of spectators at the event will range from youth to the elderly |
||
Yes |
No |
||
11. |
That VVIPs will be attending the event |
Yes |
No |
______________________________________________
For and on behalf & duly authorised by
(INSERT FULL LEGAL NAME OF THE PROVINCIAL EMERGENCY MEDICAL SERVICES MANAGER HERE)