CONSERVATION AND LAND MANAGEMENT ACT (PART 9) Commercial filming and/or photography application This application applies to persons or organisations intending to undertake commercial filming or photography activities on reserves managed by the Department of Parks and Wildlife (DPaW). APPLICATION PROCESS To assist DPaW in the proper assessment of commercial film applications and to approve lawful authorities in reasonable time, DPaW requests that all proposals be submitted at least six weeks before the expected film dates. However, shorter timeframes may be possible, if approved by DPaW. DPaW will endeavour to process all applications submitted, in time, however, should this not be possible, it is advisable that you have a backup plan either with other locations or different dates. Submit all pages of this application to: Licensing Officer, Policy and Tourism Branch Telephone: (08) 9219 9978 (International Code: + 61 8 9219 9978) Email: filming@dpaw.wa.gov.au Post: Locked Bag 104, Bentley Delivery Centre WA 6983 Your application will be forwarded to the DPaW office responsible for assessment and consideration of any local requirements. Please attach any supporting documentation to this form (e.g. scripts, production schedules, insurance information) to assist DPaW to assess your application. APPLICANT DETAILS NAME OF APPLICANT: (Person/Company/Incorporated Body only) Note: The application must be made by one person or company proposing to undertake the activity (activities) for which permission is sought. The application cannot be made using a trading/business name. If the application is by a company please provide the Australian Company Number (ACN) Name and address of directors and secretaries Name of copyright owner ALL APPLICANTS: please provide the Australian Business Number (ABN) TRADING/BUSINESS NAME: Is/are the name(s) registered? Yes No If yes, please provide the registered name(s) and the registration number(s) POSTAL ADDRESS OF APPLICANT: Note: If the applicant is a company please provide the postal address of the contact person Name of contact Email Phone 1 Website Phone 2 Fax Emergency contact name/phone number: (If different to above contact person) Page 1 of 6 DETAILS OF ACTIVITY Please attach supporting documents which detail the intent of the photography or filming to be conducted such as story boards or scripts etc. Period of proposed filming/ photography: Commencement Date Completion Date Title of film/name of program/name of product: Name any previous DPaW contact person(s): Type of film to be undertaken: (tick as Motion film Still photography appropriate) Education Advertising Purpose of still or motion film: (tick as Feature film Tourism/ appropriate) Documentary Recreation Does the film have Tourism WA sponsorship? Yes Other (please specify): No Other/partial (please specify): Sell on to a third party e.g. Image library, publisher, broadcaster (please specify third How will the still or motion film be used or shown? (tick and specify as appropriate) party and use) Editorial (please specify) Advertising or promotion of a product or service (e.g. Tours, conference, brochures) (please specify) Other use (please specify) Description of the production: (Detailed explanation of the production. Please include story boards or any other supporting documents). Page 2 of 6 ACCESS REQUIREMENTS Please attach a detailed itinerary and maps which show the areas including roads and tracks you plan to access. Please list which parks (terrestrial and/or marine) you wish to access. If accessing multiple areas of Western Australia, please list all parks. Please also attach a detailed itinerary and maps which details specific locations and roads/tracks/trails to be used. Features of interest*** Park or Reserve*** (terrestrial and/or marine) (Specify which sites, locations, routes, tracks and camping sites you intend to access within the reserve/park) Access Date *** If you require more space please use the comments sections of the form. Do you intend to access the Munda Biddi Trail or Bibbulmun Track? Do you intend to conduct any offroad/track driving/walking? For example for vantage points or to access areas in the parks listed above? Do you require roads or car parks to be closed during filming? Yes Yes No No If Yes, Please give more detail (when/where/how long): Yes No If Yes, Please give more detail: Number of people in filming party: Yes Do you intend to camp on CALM Land? No If Yes, where: Yes Will you need assistance from DPaW staff? Supervision fees may No If Yes, in what capacity: apply Will you need DPaW staff to film? Yes No Supervision fees may apply. If Yes, in what capacity and for how long: Will you be featuring Aboriginal people or items/areas of cultural significance? You may be required to Yes No If yes, please describe how you propose to depict Aboriginal people or items/areas of cultural significance: consult with or receive written approval. Contact DPaW as soon as possible, for further information. Page 3 of 6 VEHICLES AND EQUIPMENT Please attach a copy of the survey/aircraft certificates for each vessel or aircraft that will be used while on CALM land during filming, which is owned by the applicant, to ensure currency. Vehicles: Hired from another organisation or business Owned by this business/organisation (please complete the table below) Note: If you are contracting someone to provide transport to and from location you must ensure that they have a current DPaW commercial operations licence. Please provide their DPaW licence number if possible. Vehicle Type (4WD, minibus, coach, aircraft etc) Transport Licence no. Registration No. Registration Expiry (for vehicles not registered in Western Australia) Vessels: Vessel Type(s) (canoe, kayak, dinghy, charter vessel etc) SPV no./ reg. No. size of vessel (m) Number and type of cameras to be used: Will any structures or facilities be erected or does the area require any alteration to occur to allow the filming? Please detail: Other equipment: (Please list any other equipment that may be used during this operations, for example, motors, generators/lights, dolly tracks, shade shelters, vehicles, portable toilets, firearms/weapons, animal traps/snares or bait, cooking equipment.) Note: Firearms, snare, traps and bait are not to be carried on CALM land unless a licence is obtained. Licences are issued only for scientific purposes. SAFETY What steps have been taken to ensure the well being of others in your party: (Please list, for example, first aid kit, fire extinguisher, life jackets, HF radio, etc. and any other emergency response plans.) Page 4 of 6 PAYMENT OF FEES AND CHARGES Depending on the filming operation, fees and charges may apply. Please see page 4 of the Commercial Filming and Photography Handbook for the fees and charges that may be applied. The Handbook can be found via the following link: www.parks.dpaw.wa.gov.au/for-business/commercial-filming Fees and charges may be paid via the following means: Invoice, cheque or credit card and in person (you will be advised of locations you can pay). Do you request that park entry fees be waived? Yes No If Yes, for how many people*: Do you request that camping fees be waived? Yes No If Yes, for how many people*: Please ensure that you have a copy of the licence or lawful authority if issued. Camping fees may still apply. INSURANCE Please attach a copy of the Certificate of Currency for your public liability insurance. Applicants are reminded that the General Conditions in the Filming and Photography Handbook states as follows: 4.4 Public liability insurance (a) The operator agrees that at all times during the period of the licence/lawful authority they shall maintain a policy of public liability insurance for a sum of no less than $10 million per event. (b) The operator agrees to indemnify the Director General from and against liability for all actions, suits, demands, costs, losses, damages and expenses (claims) (e.g. search and rescue costs) which may be brought against or made upon the Director General caused by or arising in any way out of the conduct of the operator, its employees, agents or contractors in relation to this licence or lawful authority of the operations. CHECKLIST Yes N/A Have you completed all sections of the application form, including the deed poll section below? Have you included detailed information pertaining to the planned filming operation including specific locations and how you plan to conduct the filming on site? Have you included details of the vehicles you plan to use for the operation and/or survey certificates and provided registration and/or vessel SPV numbers? Have you included a copy of your public liability insurance policy with $10,000,000 coverage, covering all proposed activities and locations and made your insurer aware of the conditions and indemnity? Have you signed the application and had it witnessed? If your application has been submitted within six weeks of your planned dates, do you have an alternative location or set of dates should the application not be approved in time? If you have any queries please contact DPaW’s Licensing Officer on Phone: (08) 9219 9978 Fax: (08) 9334 0221 Email: filming@dpaw.wa.gov.au More information regarding commercial filming and photography can be found at DPaW’s website: https://parks.dpaw.wa.gov.au/know/commercial-filming Page 5 of 6 DEED/POLL I / We: (Full name of Organisation / Person) hereby apply for lawful authority to conduct the filming or photography operation specified in this application, and for that purpose to enter upon and use the waters and land within the areas specified in this application in order to conduct the activities specified in this application. I understand and agree that the licence if granted will be subject to the provisions of the Conservation and Land Management Act 1984 (CALM Act) and all regulations and subsidiary legislation made under it. I certify to the best of my knowledge that the information provided within this application is true and correct in every detail. I have read, understood and agree to abide by the conditions contained within the Department of Parks and Wildlife (DPaW)’s Commercial Filming and Photography Handbook, as amended from time to time, and I understand that further conditions relevant to the areas and activities proposed in this application may be imposed. I hereby agree to release and indemnify, and keep indemnified, the State of Western Australia (State), the Chief Executive Officer of DPaW (CEO) and the Water Corporation and each of the employees, contractors and agents of the State, DPaW or the Water Corporation (Indemnified Parties) from and against all: claims, demands, actions, suits, and proceedings (whether under the law of contract, tort, a written law or otherwise); and damages, liabilities, losses, costs (including legal costs) and expenses, which may be made or brought against, suffered or incurred by any of the Indemnified Parties arising in any way from, or in connection with the conduct of the applicant or any of its employees, agents, contractors the subject of this application except to the extent that any claims, actions, demands, suits, proceedings, damages, liabilities, losses or costs made or brought against, suffered or incurred by the Indemnified Parties are as a result of the Indemnified Parties’ negligence: on any lands to which the CALM Act applies; or in relation to the activities the subject of this application. I certify that the applicant’s public liability insurer is aware of the conditions that would apply to this licence and the indemnity granted above. I confirm that the applicant’s public liability policy also covers the operation and activities that are specified in this application form. The group or organisation that I represent hereby agrees to abide by the conditions of the lawful authority specified in this application. I certify that I have the authority to sign this deed poll on behalf of the group or organisation I represent. Executed as a deed on …………………………………………. (Please select the appropriate box for your situation only): DATE Natural person Company Pty Ltd (executed in accordance with section 127(1) of the Corporations Act 2001 (Cth) Incorporated Association (executed in accordance with section 14(1)(b) of the Associations Incorporations Act 1987(WA) ……………………………………………………………………… Signature ……………………………………………………..……………… Name ……………………………………………………………………… Signature of witness ……………………………………………………..……………… Name of witness ……………………………………………………………………… Signature of person with authority to bind the Company (director/secretary/authorised person) ……………………………………………………..……………… Name ……………………………………………………………………… Signature of witness ……………………………………………………..……………… Name of witness ……………………………………………………………………… Signature of person with authority to bind the Incorporated Association ……………………………………………………..……………… Name ……………………………………………………………………… Signature of witness ……………………………………………………..……………… Name of witness Page 6 of 6