Online Form - Request to Film Form


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Would you be willing to provide some raw video footage or photography to the Shire for it to use for its own purposes (after a stated time)?:

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Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx
Do you have a Risk Management Plan for this production?
Declaration: I acknowledge and agree to the following Terms and Conditions:
  1. All relevant traffic and road rules will be complied with at all times.
  2. Access to adjoining properties will be maintained at all times.
  3. Adjoining property owners will be notified of the filming schedule and activities.

The notice must include a contact name and mobile number for someone who will be on site at all times during filming.

Address details for the property and adjoining land owners can be provided by the Shire but personal information including name, email and phone details cannot be made available due to privacy legislation.

  1. The filming location must not be altered in any way and must be left in the same condition in which it was found.
  2. All equipment, temporary infrastructure and rubbish must be removed from the location at the end of filming.
  3. Your organisation will be charged for the cost of any damage or cleaning to the road, verge, footpath or other Shire assets, resulting from the filming activity.
  4. The Shire of Serpentine Jarrahdale is to be indemnified against liability for all claims that may arise as a result of filming.
  5. The Shire of Serpentine Jarrahdale is not liable for any loss, damage, theft, death or injury that occurs as a result of filming.

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx