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City of South Bend Special Event Application <br />46 <br />City and Regional Event <br />$50 application fee if filed 60 days or greater (up to 360 days) in advance of event <br />$100 expedited application fee if filed 30-59 days in advance of event <br />Review the Instructions on the Special Events page before completing the application. City and Regional Special <br />Event applications must be submitted more than 30 days in advance of the event date or the application will not <br />be accepted. <br />Section A - Applicant Information <br />Date of Application: 3_30_21 <br />Applicant (Contact) Name:Crystal Jodarski <br />Applicant (Contact) Phone:574-233-7760, <br />Address: 321 East Walter St. <br />Organization Name:__—_ YMCA of Greater Mkhiana (OBnen Centen YMCA Partnership <br />cjodarski mca <br />Contact Email: ym.or 9 g _ <br />City/State/ZIP: South Bend, IN 46614 <br />List any professional event organizer, event service provider or commercial fundraiser that is authorized to work <br />on your behalf to plan, produce and/or manage your event. <br />Organization Name: <br />Contact Phone: <br />Address: <br />Contact Name: <br />Contact Email: <br />City/State/ZIP: <br />Section B - Event Information <br />LIVESTRONG at the YMCA Sk and 1 Mile Family Fun Run Race <br />Event Name: Event Type: (Festival, Race, Parade, Other):______—______ <br />Event Classification: E Non -Profit" ❑ For -Profit <br />❑ City (Civic) Sponsored ❑ Other (If Other, please describe): <br />"The Special Events Committee may request proof of non-profit status. <br />Provide a brief description and timeline of event (Note: A detailed map plan is required in Section H of this <br />application. The description should be a summary overview.) <br />Set up: 5:30am <br />Packet Pick-up: 6:30am <br />5K Start: 8:00am (If staggared start is needed start time will be 7:30am.) <br />1 Mile Family Fun Run: 8:45am <br />Date of Event Setup [mm/dd/yy]:$=7 =2 Time: 5_30am <br />Begin Date of Event [mm/dd/yy]: $_7-21 --- -- -------- —__ Time: 8:00am <br />End Date of Event [mm/dd/yy]: 8-7=21 .......... —__.... Time: 1 1 _00am <br />Event Cleanup Completion [mm/dd/yy]: 8-7-21 ___ 12:00_ <br />Pm <br />—---------Time:-------— <br />Total anticipated attendance: 200 <br />The proposed event will require the closing of: ® Streets 11 Sidewalks <br />