Before you apply

Fitness and Personal Training Licence Application Form

Before you apply

Running outdoor fitness classes? Apply for a Personal Training Licence.

Please read before applying

• Personal Training Licence webpage 
  

• Fitness Training Policy

• Fitness Training Conditions of Use
  

Documents required to include with your application

• Valid First Aid certificate & CPR

• Public liability insurance Certificate of Currency ($20m minimum)

• Peak body registration (Fitness Australia, Physical Activity Australia, Fit Rec)

• Risk and emergency management procedures

• Participant waiver form

• A detailed site map
  

Contact and business details

Contact and business details

Name of business *

ABN *

First name *

Last name *

Email *

Contact number *

Alternate number

Postal address *

Street address *Street address line 2

City *

State *Please selectACTNSWNTQLDSATASVICWA

Postcode *

CountryPlease selectAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiComorosCongo (Brazzaville)CongoCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe

Operation details

Operation details

Location *

Days of operation *

MondayTuesdayWednesdayThursdayFridaySaturdaySunday

Monday hours of operation *Must be between the hours of 6 am and 8 pm

Tuesday hours of operation *Must be between the hours of 6 am and 8 pm

Wednesday hours of operation *Must be between the hours of 6 am and 8 pm

Thursday hours of operation *Must be between the hours of 6 am and 8 pm

Friday hours of operation *Must be between the hours of 6 am and 8 pm

Saturday hours of operation *Must be between the hours of 6 am and 8 pm

Sunday hours of operation *Must be between the hours of 6 am and 8 pm

Include a second/backup location? *

YesNo

Location *

Use the same days and hours as the primary location

Days of operation *

MondayTuesdayWednesdayThursdayFridaySaturdaySunday

Monday hours of operation *Must be between the hours of 6 am and 8 pm

Tuesday hours of operation *Must be between the hours of 6 am and 8 pm

Wednesday hours of operation *Must be between the hours of 6 am and 8 pm

Thursday hours of operation *Must be between the hours of 6 am and 8 pm

Friday hours of operation *Must be between the hours of 6 am and 8 pm

Saturday hours of operation *Must be between the hours of 6 am and 8 pm

Saturday hours of operation *Must be between the hours of 6 am and 8 pm

Supporting documents

Supporting documents

Please upload copies of the following:

A detailed site map *

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This should include exclusion zones, signage and temporary infrastructure

First Aid Certificates *

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Medical/Participant Waiver Form *

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Certificate of Currency ($20 million) *

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Public Liability Insurance ($20 million) *

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Detailed Risk Management Plan *

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If your activity requires an in-water element, please provide details of entry and exit points and in-water safety procedures.

View this  Risk & Emergency Management Plan Template as an example

Does your Risk Management Plan include an Incident Response Plan? *

YesNo

Incident Response Plan *

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Does the business/activity work with children? *

YesNo

When the business works with children, all staff/operators must have current Working With Children Checks (WWCC) and Victorian Child Safe Standards in place.

Working With Children Check (WWCC) *

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Child Safe Standards *

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Activity details

Activity overview

Provide a detailed description of the type of activity to be delivered *

Explain how the proposed activity provides health and wellbeing opportunities to support and improve the lives of the community *

List all equipment that will be used *This must all be minimal, under 15kg or less

Compliance and accessibility

Compliance and accessibility

What actions are in place to ensure there is minimal impact to community enjoyment of public open space and local amenity? *

How does the proposed activity provide a safe and inclusive environment for everyone in the community to participate? *

Declaration and agreement

Declaration and agreement

Data privacy and collection

The personal information requested on this form is being collected by the City of Port Phillip (CoPP) and will be handled in accordance with the Privacy and Data Protection Act 2014. This information will be used solely by the council for that primary purpose or directly related purposes. It will be treated in compliance with the CoPP Information Privacy Policy and the Information Privacy Act. During the application and assessment process, information will be kept confidential, however, some details of proposals may be made public as part of the Council meeting and decision-making process.

Yes, I give permission for the City of Port Phillip to store and process my data. *

Agreement

I certify that all details supplied in this EOI application form and the attached documents are true and correct to the best of my knowledge, and that the application has been submitted with the full knowledge and agreement of the management of the applicant organisation or auspicing body. *

I agree to contact the City of Port Phillip if any information regarding this application changes or is found to be incorrect. *

Signature *

Clear

 

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