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1. Media Accreditation Application Form
First Name:
Last Name:
Postal Address:
Suburb:
State:
Postcode:
Phone:
Mobile
Email:
Emergency Contact:
Phone:
2. Organisation Details
Media Organisation Name:
Editor or Team Principal's Name:
Postal Address:
Suburb:
State:
Postcode:
Phone:
Mobile
Email:
Type of Outlet:
Newspaper
Magazine
Radio
Team
National Press
TV
Website
Freelance
Please list all publications/agencies that will be publishing or broadcasting your work:
Audience - Please indicate where reports or photos will be circulated or broadcast
Local (Region):
Statewide:
National:
International:
3. Accreditation Details
Do you have CAMS Accreditation?
Yes
No
If 'Yes', what level and type?
Do you have FIA Accreditation for 2011?
Yes
No
If 'Yes', what level and type?
4. Accreditation Categories (please select one)
Level 1 Photo Provides:
Access to official Media Centre.
Access to prescribed media areas at spectator and media points.
Access to Service Park, and where invited by a team/competitor, inside team allocated areas at the Service Park.
Access to other areas, in particular to with the media competitive stages, subject to compliance with the media code of conduct policy.
Level 1 Print Provides:
Awarded to print journalists personnel with appropriate commissions from media outlets.
Level 2 Photo Provides:
Access to official Media Centre.
Access to allocated spectator areas at spectator and in areas specified by officials at media points.
Access to Service Park, and where invited by team/competitor, inside team allocated areas at the Service Park.
5. Insurance Public Liability
IMPORTANT:
2011 Alpine Media Accreditation does NOT include either Public Liability Public Risk Insurance, or Personal Accident Insurance, which are the responsibility of the accredited person. Anyone wishing to apply for Level 1 Photographic Accreditation must provide:
a) Evidence in the form of a letter written in English, from the Photographer’s or Agency’s insurer or insurance broker confirming that they have, or are covered by, public liability insurance covering his or her actions of at least AU$10 million per claim, during the event.
b) A copy of current Occupational Health & Safety for lodgement with CAMS and the ARC.
c) A copy of their current CAMS Photographic Accreditation and a signed copy of the CAMS Occupational Health & Safety Policy
6. Please Note
Media Accreditation will be issued at the discretion of the Media Manager.
No “blank” passes will be issued.
Associates or “Visitors” attending with accredited media are not granted access rights.
Alpine accredited media must wear a Hi-Vis Photographer’s Vest to gain unrestricted access to competitive stages.
Passes and Photographer Vests will be issued to successful applicants subject to their Media Organisation or Publication (or the individual themselves if applicable) signing the Alpine application form. Accreditation is
NOT
transferrable
7. Accreditation
Example(s) of work of previous rally assignments.
A letter written on the company letterhead of the media publication or organisation or Alpine team which you represent signed by the Editor (or team principal) confirming your association with that organisation.
Copy of current Public Liability Insurance.
A copy of your current OH&S Policy.
A copy of your 2011 CAMS Accreditation (if applicable).
8. Declaration
Please tick this checkbox if you agree to the above
PLEASE RETURN SUPPORTING DOCS BY
FRIDAY 14TH OCTOBER 2011
TO:
Paul Mollison
2011 Alpine Rally Media Manager
media@alpinerally.org.au
Submit Application
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