This is an application for filming at Fremantle Prison. All requests to film must gain
prior approval from Fremantle Prison.
Please ensure you have read Fremantle Prison's Filming Policy prior to submitting anapplication. The policy outlines the terms, conditions and fees applicable.
If the information provided in this application is inaccurate it may lead to thecancellation of an approval at any time. The following document is an application
only. Requests are not considered approved until you have received written
confirmation from Fremantle Prison.
Applicant Details
Full namePosition
Organisation name
ABN
Organisation address
Phone number
Mobile number
Email address
Production Details
Name of Production
Production Summary/Synopsis/Script
Attach script if space isinsufficientType of Production (please tick appropriate box):[ ] Feature[ ] TV Drama[ ] Documentary[ ] TV Commercial[ ] Corporate Video[ ] Short Film[ ] Music Video[ ] Student Film[ ] Other (please specify)___________________________________________

Filming Details
Please be sure to provide as much detail as possible in order for your application tobe assessed.
Proposed Filming Date
Proposed Filming Start Time
Proposed Filming End Time
Proposed Site Access Hours
Proposed Filming Locations
within Fremantle Prison

Please specify buildings/areas
to be used and specify a usefor each area

Operational Requirements
Approximate total number ofcast and crew
Approximate number ofvehicles on siteWill any scenery/sets beconstructed on site. If yes,
please specify*Please note, no items can be
affixed to the buildings

Please describe equipment tobe brought on site

Conditions of Approval
If your filming application is approved, you will be responsible for crew inductions
and you may be required to manage a number of sensitive issues relating to the useof this significant heritage site.
I / We agree that by being granted permission to film or record within the Fremantle
Prison precinct, I / we undertake: To respect the highly significant cultural history and built heritage fabric ofFremantle Prison, and not to depict the Prison or anything associated with itin a manner that is derogatory or demeaning in any way;
 To cooperate with and abide by instructions given by Fremantle Prison
personnel at all times;
 To not disrupt the normal operating activities and tours of Fremantle Prison
and undertake the filming within the scope of the project and timeframe
agreed with Fremantle Prison;
 To not shift or remove any material without the express written approval of
Fremantle Prison personnel;
 To not damage the building/s or materials; and to pay for any damages orcosts incurred by the Department of Planning, Lands and Heritage as a resultof filming;
 To not affix or attach any props, backdrops, lighting or any other item to thebuildings, walls and fixtures within the Prison precinct;
 To take all reasonable precautions to ensure a safe working environment for
all people associated with the filming and for the security of equipment andpersonal property of participants whilst on site; and To discharge Fremantle Prison, the State of Western Australia and its
respective servants and agents, to the extent permitted by law, from any
claims for loss, damage or injury arising from this filming.

I _____________________________, have read and agreed to the terms andconditions outlined in this document.
[ ] Yes[ ] NoName of applicant__________________________________

Signature of applicant__________________________________

Date document signed__________________________________