SPECIAL EVENT PERMIT APPLICATION FORM



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SPECIAL EVENT PERMIT APPLICATION FORM (To be completed by the requesting sponsor at least 30 days prior to event) Date: Permit #: Name of Applicant: Mailing Address: Home Phone: Other Phone: Name of Event: Event Sponsor: Mailing Address: Business Phone: Is the event sponsor a charity or non-profit organization? YES NO Date(s) of Event: Time(s) of Event: Where will the event take place? Trailblazer Park Events: Will you require the use of the stage owned by the City for this event? YES NO If yes, see attached stage policies and rental agreement. Will your event use amplified sound? YES NO If yes, what will it be used for? Please provide a brief description of the

Estimated attendance for the entire event: Estimated percentage of attendants who will make up the following age groups: 15 and younger: 21-25: 36-45: 16 to 20: 26-35: 45 and older: Do you plan to sell food? YES NO If yes, describe which type of foods and beverages are to be served: Will alcoholic beverages be served at the event? YES NO If yes, describe which types of alcohol are to be served: Describe any power needs at the Describe any revenue to be generated at the Describe necessary security and medical provisions for attendees. The City may require off duty police officers for certain events. This will be determined by the City Administrator and the event organizer is responsible for payment directly to the officer(s). Rain policy for the event: Please list the person(s) of authority who will be in charge during the event: Name Address Mobile Phone # Other relevant information pertaining to the 2

Hold Harmless Clause Permittee/sponsor hereby shall assume all risks incident to or in connection with the permitted activity and shall be solely responsible for damage or injury, of whatever kind or nature, to person or property, directly or indirectly arising out of or in connection with the permitted activity or the conduct of permittee's operation. Permittee hereby expressly agrees to defend and save the City harmless from any penalties for violations of law, ordinance, or regulation affecting its activity and from any and all claims, suits, losses, damages or injuries directly or indirectly arising out of or in connection with the permitted activity or resulting from the negligence or intentional acts or omissions of its officers, agents and employees. I, (please print name), have received and read the City of Travelers Rest Hold Harmless Clause, and understand it in its entirety. Signature of Applicant Title Date Police Approval / Date: Comments (including number of officers required for event to be permitted) City of Travelers Rest, City Administrator Signature Date If the City Administrator determines that it is necessary to have one or more off-duty police officers at the event, the event organizer is responsible for payment directly to the officers prior to the start of the event. The rate is $30 per hour per officer. There is a two hour minimum required. Signature of Applicant 3

Trailblazer Park Reservation Policies The City of Travelers Rest reserves the right, on an individual basis, to refuse rental to events deemed inappropriate. Rental fees are subject to change without notice. The City events take precedent over any other scheduled events. Additional policies and restrictions may apply. Any regulations not adhered to under these policies and enforced by the responsible party will result in the group being barred from future use of the stage. A. Reservations: Reservations are not valid until a rental contract has been signed by all parties specified on the Special Events Application. All fees must be payable in by cash, check or money order only. Subleasing is prohibited. B. Hours: Rental hours are from 7:00 am until 12:00 midnight. Failure to vacate by the designated time listed on the Special Events Application will result in loss of your security deposit and may include extra fees. C. Deposits and fees: There are two required deposits that must be paid at the time the rental contract is signed: the Rental Deposit that will be applied toward the balance that is owed, and the refundable Security Deposit for additional clean-up or for damages. The balance of fees must be paid no later than one week prior to the event. Additional rental fees may be incurred for failing to comply with regulations. D. Cancellation: Rental fees and deposits will be refunded for events cancelled at least one week in advance. If the event is cancelled less than one week in advance, the security deposit will be forfeited and the rental fees will be returned. E. Set-up and decorations: Fees will be applied in accordance to the fee schedule for sound equipment and banners. All decorations must be approved by the City prior to the event, and shall be removed immediately after the event's conclusion. In addition, all entertainment equipment shall be removed and vacated from the stage within thirty minutes following the event. F. Security: If the stage is set up the day prior to the event, city overnight security costs will be billed to the renter. G. Damages: Damages for which the renter is responsible include, but at are not limited to, scratches or other damage to floors, walls, stairs, stage skirting, stage power cords, whether made by the renter, his employees, agents, volunteers or guests. Incurred damage and cost of repairs will be determined by the City Administrator. H. Explosives: Possession and/or use of fireworks, & explosives are strictly prohibited. I. Tobacco use: Use of tobacco products is prohibited in the park, including the stage area. J. Right to alter or end an event: The City of Travelers Rest maintains the right to alter or end any event at any time it deems necessary to assure the continued public safety, health, and welfare of event participants. In the event a function is ended for cause, no refund will be made. Any person violating the existing rules and regulations at the City's discretion shall be expelled from further use of the stage and prosecuted in accordance to state and local laws. Park Rental Agreement 4

Name: Street Address: City: State, Zip code: Home Phone: Other Phone: Renter Information Event Name: Event Location: Rental Date(s): Rental Times: Event Information Rental Fees: $150.00 per day for non-profit organizations; $300.00 per day for others Deposits: Rental payment is due if full before the permit can be issued, In the event of cancellation, the City will retain a $100 rental deposit and the remaining balance is refundable. A refundable $100 security deposit payable at the time of reservation. The security deposit will be refunded following City inspection of the facilities after the event. I, (please print name), have received and read the City of Travelers Rest Stage Reservation Policy. I understand that failing to adhere to the policy may result in the loss of my security deposit and additional action by the City to recoup any damages or losses. Signature of Applicant Title Date City of Travelers Rest, City Administrator Signature Date 5