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rn City of South Bend Special Event Application <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 />Please Brine Completed Aoolication and Payment to: <br />Public Works Service Center, 731 S. Lafayette Blvd., South Bend, IN <br />• <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 />Date of Application: 04/27/2024 <br />Applicant (Contact) <br />Applicant (Contact) Phone: <br />-S •1 _,.1 1:i •1 <br />Tom Carter <br />574-286-5594 <br />Organization Name: Stanley Clark School <br />Contact Email: scarter829@gmail.com <br />Address: 3123 Miami Street City/State/ZIP: South Bend, IN 46614 <br />List any professional event organizer, event service provider orcommercial fundraiser that is authorized towork <br />on your behalf to plan, produce and/or manage your event. <br />Organization Name: <br />Contact Phone: <br />Event Name: <br />Clark Run 5K <br />Contact Name: <br />Contact Email: <br />City/State/ZIP: <br />Section B - Event Information <br />Event Type: (Festival, Race, Parade, Other): Race <br />Event Classification: B 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 />This is the 1 Ith Annual Clark Run. It's a 5K Run and a 3.5K Walk. Both events start at 10:00 AM. We will <br />be using the same course route as in years past. <br />Date of Event Setup [mm/dd/yy]: 10/5/2024 Time: 8:30 AM (Registration) <br />Begin Date of Event [mm/dd/yy]: 10/5/2024 Time: 10:00 AM (Run/Walk Starts) <br />End Date ofEvent [mm/dd/yy]: 10/5/2024 Time: I1:00 AM (Race Completes) <br />Event Cleanup Completion [mm/dd/yy]: 10/5/2024 Time: 12:00 PM (Event Closes) <br />Total anticipated attendance: 200-300 <br />The proposed event will require the closing of: ❑x Streets ❑ Sidewalks <br />