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Application for Special Event

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The chair of the special event committee must receive applications at least 30 calendar days prior to event, but not more than one year. Per Chapter 116, City of Clearwater Code of Ordinances, the 15-working day period for review does not begin until the completed application, including all required attachments, has been submitted.

Applicant must provide with application a legible site plan or map. Site plans must include details regarding all operational equipment (tents, barricades, portalets, dumpsters, etc.) and other information needed to describe the event. If road closure is requested, the site plan must show proposed Maintenance of Traffic plan. Please e-mail the site plan or map to Ralph.Shaw@myclearwater.com .

ALL fields below are REQUIRED unless otherwise indicated.

General Event Information:

Name of Event:

Location of Event:

Date(s) of Event (if recurring event, list specific dates in Description area below):
Start Date:

End Date:

Alternate Date(s) of Event (if any - not required):
Alternate Start Date:

Alternate End Date:

Hours of Event:

Setup and Breakdown Dates/Times:
Setup Begin Date:

Setup Begin Time:

Breakdown Completion Date:

Breakdown Completion Time:

Purpose of Event (Why is event taking place?):

Description/Activities of Event (Details of Operations):

Number of Participants:

Number of Spectators:

Applicant:

Name of Organization/Individual:

Address (including City, State, and Zip Code):

Authorized Person in Charge:
Phone Number (Primary):

Phone Number (Other, if any - not required):
Phone Number (Fax, if any - not required):

E-mail:

Type of Special Event (Select ONE):

Class 1A, private event, closed to the public ($100 non-refundable processing fee required)
Class 1B, private event, open to the public ($100 non-refundable processing fee required)
Class 2A, City of Clearwater sponsored event
Class 2B, City of Clearwater department-sponsored event: Department?:
Class 3A, City of Clearwater co-sponsored event approved by the City Council
Class 3B, City of Clearwater co-sponsored event approved under the special development code
Class 4, City of Clearwater approved Park Usage event. (Events generally under 75 people)
Class 5, City of Clearwater approved Block Party

Event Components, Activities, & Forms (Select ALL that apply):

Amplified sound will be used
Fee Schedule for Bandshell or Beach Venues
Fireworks
Insurance, $1,000,000 liability for 50+ persons
Parades or racing events*
Parking, special needs
Port-a-lets
Trash containers & clean-up
Food or beverage/free (Food prep/cooking on-site? )
Food or beverage/sold (Food prep/cooking on-site? )
Alcohol/free or sold
Retail sales
Giveaways (non-food/beverage)
Road closure request (M.O.T. required)
Inflatables (insurance required from provider)
Security and/or public safety concerns
Traffic maintenance
Signs and banners
Tents/Canopies 150 sq ft or larger
Tents/Canopies less than 150 sq ft
Venue diagram (site plan required)

*$.25 head count fee for road races (post race)

Notes:

Alcohol not permitted on City property unless with an approved City sponsored event or indoors at an approved recreation center.
Beach venues- no open flame, no food or beverages sold and no retail sales permitted other than event merchandise.
Events not sponsored by the City may require a Business Tax Receipt ($255.10) prior to the commencement of each promotion.

Applicant Certification (required):

I hereby certify that I have read this application and that all information contained herein is true and correct to the best of my knowledge, information and belief. I agree to comply with all Statutes, County and City Ordinances, and the general instructions stated in this application and the special conditions issued by the City in connection with the approval of the Special Event contemplated herein. I, and the organization on whose behalf I make this application, if any, represent, stipulate, contract and agree that we will, jointly and severally, defend, indemnify, save and hold the City harmless from any and all claims, lawsuits, judgments, and liability for death, personal injury, bodily injury, or property damage arising directly or indirectly from the exercise of the Special Event Permit and performance of the Special Event by Applicant, the organization represented by Applicant, its employees, subcontractors, or assigns, including acknowledges that he/she, together with any organization represented by Applicant, shall be solely responsible by complying with the terms of the Permit. I further understand that failure to comply with any of the provisions specified herein, or the unauthorized modifications of any event parameter, may result in immediate cancellation of this event by City officials. Applicant must be 18 years of age or older. The non-refundable application processing service fee must be submitted at the time of application. Please make all checks payable to the City of Clearwater. If you have questions, please call 727-562-4805.

Checking this box represents your electronic signature, indicating that you agree to the terms and condtions described above. Please note that you may be required to provide a physical signature during the event authorization process after submitting this form.

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