Power & Risk Assessment Form Rockhampton Expo - Power and Risk Assessment FormInstructions All Exhibitors are requested to complete and submit this form at least 3 weeks prior to the event. This form is an integral part of your display and must be completed by an authorised person. Please note that Power ordered late (within 3 weeks of an event) incurs a $50.00 surcharge. Ordering power late by submitting this form does not guarantee that power will be provided to your site. All power requests must be approved and paid in full before power will be made available. If you have any issues submitting this form, contact Australian Events on FREECALL 1800 671 588 during business hours. Authorised Company Contact DetailsInstructions Please provide details of the authorised company contact and the event you are submitting details for. Company Name * Site Number Authorised person completing this form * Authority to submit this form *I am authorised to submit this form on behalf of the company listed above Authorised Contact Email * On Site Contact Person * On Site Contact Mobile * Compulsory Power Requirements and ItemsPower Required *We DO NOT Require PowerWe have already ordered Power (please complete the list below of items you are bringing)YES we require 10amp Power $95.00 (Single Power Outlet) (please complete the list below of items you are bringing)YES we require 15amp Power $175.00 (Single Power Outlet) (please complete the list below of items you are bringing) We will be bringing the following electrical items. Please list all the electrical items you will be bringing, including wattage and quantity. Please note kettles and electric heaters are not permitted. Compulsory Risk Assessment FormRisk Assessment THIS SURVEY MUST BE COMPLETED AND SUBMITTED BEFORE YOUR SITE WILL BE APPROVED FOR SET UP. Your site at our event is an extension of your workplace and therefore Occupational Health and Safety legislation applies. It is your responsibility to inform your staff of any hazards and ways to avoid injury to staff and visitors alike. You are responsible for ensuring the safety of the public and that they are not exposed to hazards on your site. Australian Events reserves the right to inspect your site at any time during the course of an event to ensure that you have complied with Occupational Health and Safety regulations. Please indicate below any potential health, safety and risks associated with your site and display. If you have none, simply indicate "Not Applicable". FIRE HAZARD This hazard is very dangerous. List any items or practices which may cause or exacerbate fire hazard. Please list all gas bottles and any flammable substances. Do you have any Fire Hazard Risks *YesNo If YES, Fire Hazard risk details TRIPS, SLIPS AND FALLS List any items or practices which may cause or exacerbate the hazard including slippery surfaces, guy ropes, tent pegs, any objects which may be subject to instability. Do you have any Trips, Slips or Fall Hazards *YesNo If YES, Trips Slips and Fall risk details EQUIPMENT, PLANT AND MACHINERY List any items or practices which may cause or exacerbate the hazard including stationary and mobile equipment and any dangerous components that you may have including sharp objects. Do you have any Equipment, Plant or Machinery Hazards *YesNo If YES, Equipment Plant and Machinery risk details DANGEROUS GOODS, HAZARDOUS SUBSTANCES AND CHEMICALS List any items or practices which may cause or exacerbate the hazard. Do you have any Dangerous Goods, Hazardous Substances or Chemical Risks *YesNo If YES, Dangerous Goods, Hazardous Substances and Chemical risk details OTHER HAZARDS List any items or practices which may cause or exacerbate the hazard. Do you have any other Hazards *YesNo If YES, Other Hazard risk details ADDITIONAL INFORMATION. Please provide any other information that you believe relevant to your site which you believe may be useful to Australian Events. Email Email VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank WIN PASSESJoin our email newsletter to go into the draw to win passes to the Expo. ENTER NOW! THANK YOU FOR ENTERING!