The University of Texas at San Antonio Joint Sponsorship Application For All UTSA/Internal Hosts and Invited/External Hosts

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The University of Texas at San Antonio Joint Sponsorship Application For All UTSA/Internal Hosts and Invited/External Hosts utsa.edu/events/cohost, 1 Please complete all sections of this application. This application is the first step in requesting approval to host an event at The University of Texas at San Antonio ( UTSA ). Complete and accurate information is essential. Approval will be based on the information submitted on this application. The application process may take up to sixty (60) days and must comply with all UTSA policies and procedures as stated on the Joint Sponsorship website at www.utsa.edu/events/cohost. At UTSA, a joint sponsored activity is any event, camp, conference, meeting or program that takes place on any of the UTSA campuses/facilities, that occurs only after UTSA extends an invitation, and that is hosted by an UTSA/Internal Host and an Invited/External Host unaffiliated with UTSA. In order for joint sponsorship to be appropriate, the educational implications of a program or activity must be self-evident, must directly supplement the educational purposes of the UTSA. Once completed, submit application to the appropriate UTSA event office (by campus): Main Campus Events Management & Conference Services One UTSA Circle, San Antonio, TX 78259 P: (210) 458-4155, F: (210) 458-6271 E: EMCSevents@utsa.edu Downtown Campus Extended Education & Special Events P: (210) 458-2411, F: (210) 458-2410 E: Frank.Salazar@utsa.edu 501 Cesar E. Chavez Blvd., San Antonio, TX 78207 Or Senior Vice Provost for UTSA Downtown P: (210) 458-2712 F: (210) 458-2424 E: kc.gonzalez@utsa.edu HemisFair Park Campus ITC Facility Rental Department801 Cesar E. Chavez Blvd, San Antonio, TX 78205 P: (210) 458-2275, F: (210) 458-2278 E: Jennifer.Collazo@utsa.edu Section 1. UTSA Contact Information (To be completed by UTSA Internal Host) Contact information of the UTSA/Internal Host requesting joint sponsorship. The UTSA/Internal Host sponsoring the event will be the primary contact for the details of the joint sponsorship and must be present at all activities. Name of UTSA/Internal Host (Department/Unit): UTSA Contact Name & Title: Office Location Number: Campus: Main Downtown ITC Telephone: Fax: Cell Phone: Email Address: Name of UTSA Department or Administrative Head (Print): Signature of Department or Administrative Head in this section indicates review and approval of this event: rev 9/3/15 (Based on BORR revisions 5/14/15)

utsa.edu/events/cohost, 2 Section 2. Non-UTSA Contact Information (To be completed by Non-UTSA External Host) Contact information of the Invited/External Host requesting to use UTSA facilities and services who will be cohosting this event, activity or program. Name of Invited/External Host (Organization/Association): Contact Name: Website: Address: City, State ZIP Telephone: Fax: Cell Phone: Email Address: Type of External Organization!For-Profit!Non-Profit!UT Component!State Agency Has this event been held at UTSA in the past?!federal If yes, explain:!schools Section 3. Event Details The UTSA/Internal Host will be responsible for all details of the program, activity or event. Advertising should not begin prior to receiving approval. All advertising and news releases for this event must be approved in writing by UTSA Communications & Marketing prior to publication or dissemination. This includes, but is not limited to, all advertisements in any newspapers, magazines, on the internet, journals, brochures, radio, television, invitations, apps, texts or email-invitations. Event Title: Event Date: Event Time(s): Event Description: (attach agenda) Anticipated number of attendees: Is the event open to the public?! YES! NO Are UTSA students, faculty, staff or other UTSA guests invited? Will minors participate? How will you advertise for this event?! YES! NO! YES *! NO If Yes: Age Group: See Event Risk Management section below.

utsa.edu/events/cohost, 3 Event Risk Management* Insurance* UTSA may require General Liability insurance and Excess Accident insurance for joint sponsored events on UTSA s campuses/facilities. This requirement can be satisfied by providing additional insured status for UTSA on an existing, acceptable general legal liability insurance policy or by purchasing a policy to cover the event and use of UTSA facilities. Liability and Excess Accident insurance may be purchased through UTSA or from an outside insurance agency. When the event requires insurance, provide a certificate of insurance indicating at least $1 million in coverage limits and include UTSA and the University of Texas System s ( UT System ) Board of Regents as the certificate holder and as an additional named insured for the event and use of facilities. An additional UT System camp program insurance application may be required. Send the certificate of insurance to the appropriate UTSA Event Offices (see above) as soon as possible, but no less than fourteen (14) days prior to the event. The Environmental Health, Safety & Risk Management office may require additional insurance or place other restrictions or conditions on the event depending upon the size, location or nature of event. Indemnification Forms* UTSA Indemnification Forms may be required for minors or adults, based on activity. The internal host must collect and keep all forms for three years. Texas Education Code 51.976 1 The Invited/External Host is also referred to as the Program Operator for the purpose of this paragraph. Texas Education Code 51.976 was enacted in September 2011 and requires all who work/volunteer in programs/events on campus involving contact with minors complete a Department of State Health Services (DSHS) approved Training and Examination Program on Sexual Abuse and Child Molestation ( Training ). The Training must be completed within the first five (5) days of employment with the program/event and Program Operators must submit a verification form to the DSHS within five (5) days of the start of the program/event verifying that each employee/volunteer of the campus program/event has complied with the training requirement. For a complete list of requirements, visit: https://www.utsa.edu/acrs/training/sb1414_training.html and https://www.utsa.edu/acrs/sb1414/sb1414faqs.pdf. Information regarding compliance with UT System regulations is also found at http://www.utsystem.edu/bor/procedures/policy/policies/uts124.pdf. The Program Operator shall be responsible for the Training requirements for all employees and volunteers of the campus program/event at UTSA. Upon request by UTSA, the Program Operator shall provide proof verifying that each employee/volunteer of the campus program/event at UTSA has completed the Training. The Invited/External Host agrees to indemnify and hold harmless UTSA, its governing board, officers, representatives, employees and agents from liability for the injury or death of event participants, guests and outside entity s employees, agents, representatives, staff, and volunteers as well as for any damage to property that may occur during the course of the event, REGARDLESS OF THE CAUSE OF SUCH INJURY, DEATH OR DAMAGE TO PROPERTY. Section 4. General Information UTSA is required to comply with all UT System Board of Regent Rules Series 80105 and UTSA Handbook of Operating Procedures Chapter 8.5 pertaining to joint sponsoring events on UTSA s campuses. UTSA does not allow any political or religious activities to be Joint Sponsored on UTSA campuses. 1 Please note: there are two sections 51.976 in the Education Code.

utsa.edu/events/cohost, 4 General Program/Activities Questions A. Explain how this event supplements the educational purposes of the UT System or UTSA. B. Does this event have any relation to a political activity? Answers and Comments C. Does this event have any relation to a religious activity? D. Are you requesting any other entities to come onto campus for any part of your event? (e.g., fence company, port-a-johns, staging equipment, vendor fair set-up, decorating company, etc.) If yes, Explain: Section 5. Financial Obligations UTSA may require an accounting of the income and expenses directly related to the program or activity. General Program/Activities Questions A. Will there be a fee charged either directly, indirectly through a conference/meeting fee, or through selling a ticket for participation in the event?! No Answers and Comments!Yes Amount: $ If yes, Explain: B. Will merchandise be sold in association with this event? If yes, explain/describe: C. Describe the nature of your revenue sources. Section 6. Room/Space Needs Describe type of room(s) /space / housing needed: Type of Space Requesting Quantity Dates Times Small meeting room(s) up to 35 Medium size meeting rooms(s) up to 100 Large meeting room(s) Outdoor space(s) Housing Section 7. Additional Considerations The appropriate UTSA Events Office for each campus (see pg.1) will provide assistance with UTSA offices such as Environmental Health, Safety & Risk Management, Parking and Transportation Services, UTSA Police,

utsa.edu/events/cohost, 5 Facilities Services, Academic Technology, Alcohol, Catering, etc. Of the two co-hosts, the UTSA/Internal Host sponsoring the event will be the primary contact for the details of the joint sponsorship and must be present at all activities. However, the Invited/External Host fully understands that even after issuing the Letter of Invitation, UTSA can place additional restrictions, requirements, cancellations or conditions on the hosting of the event and the Invited/External host agrees to comply with these restrictions, requirements, or conditions. Please consider planning for the following for a safe and successful event: Access to first aid and medical attention for event participants. Potential risk associated with coordinating an event for minors. Parking for event participants. Logistics of transportation and charter services if participants will be transported to and from venues for your event. Program Operator/Director/Coordinator camp with minors requirements (For more information, visit https://www.utsa.edu/acrs/training/sb1414_training.html) Information regarding Texas compliance is also found at http://www.utsystem.edu/bor/procedures/policy/policies/uts124.pdf. Section 8. Signatures By signing below, I agree that my organization will abide by all UT System rules and regulations and UTSA policies and procedures and all terms and conditions in this Joint Sponsorship Application. I represent that I have the authority to bind my organization to the terms and conditions in this Joint Sponsorship Application and that the information provided in this application is true, accurate and complete. I understand that UTSA will rely on this information and my representations to make a decision to approve or deny the request. I further understand that this Joint Sponsorship Application is only the first step in obtaining UTSA s approval to hold the proposed event, program, or activity on UTSA campus property. UTSA has the right to request and/or consider additional information for this event. Advertising should not begin prior to receiving approval. If UTSA approves the holding of such event on UTSA property, UTSA s approval will be in the form of a letter of invitation. By signing this application, your organization understands it will be financially responsible for all expenses related to this event. Invited/External Host Print Name: Title: Signature: Date: UTSA Campus: For UTSA Events Offices Date of Inquiry:

utsa.edu/events/cohost, 6 Application Packet Sent: Routed For Approval: Application Received: Approval Received/Denied: