HomeMy WebLinkAboutPark Use Application designedAPPLICATION FOR RENTAL OF SOUTH BEND PARKS
SECTION 1 - APPLICANT INFORMATION
Date of Application: _____________________________________________
Applicant (Contact) Name: ______________________________________________________________________________________________________________________
Applicant (Contact) Phone: _____________________________________________________ Alt. Phone: ____________________________________________________
E-Mail: ________________________________________________________________________________________________________________________________________
Address: _______________________________________________________________ City/State/Zip: _______________________________________________________
Organization Name: ____________________________________________________________________________________________________________________________
SECTION 2 – EVENT INFORMATION
Event Name:_________________________________________________________________________________________________________________________________________
Is this a return event? □ Yes □ No Previous Date: ______________ Previous Venue: _____________________ Previous Attendance: _______________
Type of Event: □ Private (Invite Only/Guest List) □ Public (Open for Public/Anyone can Attend)
Type of Event: □ Community/Neighborhood Picnic/Fair □ Large Festival/Fair □ Service or Meeting □ Fundraiser □ 21+ Only
(Select all that apply)
□ Processional Event (Walk/Run) □ Other (Please specify:___________________________________________________)
Name of Park Requesting:__________________________________________________ Specific Site in Park:________________________________________________
Event Date Requesting:_________________________________________________ Rain Date/Alt Date: ___________________________________________________
Anticipated Attendance Range: □ 1 - 75 □ 75 - 150 □ 150 - 500 □ 500 - 1,000 □ 1,000+
Event Start Time: __________________________________ Event End Time:____________________________________
Set-Up Date: ______________________________________ Set-Up Time: _______________________________________
Tear-Down Date: __________________________________ Tear-Down Time: ___________________________________
Is the event ticketed? □ Yes □ No If yes, how much are tickets? $_________________________________
How can the public purchase tickets? □ Before the event only □ Before the event and at the door □ At the door only
Is the applicant working on behalf of another organization? □ Yes □ No
If yes, organization name: __________________________________________________
Will the event require use of electric? □ Yes □ No Will the event require use of water? □ Yes □ No
Note: Water and electric are not guaranteed in any park. Water turn-on is dependent on season and weather conditions.
Brief Description of Event: ________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________
SECTION 3 – EVENT LOGISTICS
FOOD:
Will an outside company or caterer be preparing and/or serving food in the park for this event? □ Yes □ No
IF YES:
The event must apply for any necessary health permits and submit proof of approved permit to SBVPA within 1 (one) week of event. Each food vendor must also obtain necessary permits to
serve on-site and must display these permits at the event.
Health Department Contact: (574) 235-9723 and/or visit www.sjchd.org.
ALCOHOL:
Will there be beer and/or wine served at the event? □ Yes □ No
IF YES:
The event must purchase an alcohol permit from the Indiana State Excise Department and submit proof of approved permit to Venues Parks & Arts no later than 1 (one) week before the event.
Excise Contact: (574) 264-9480 and/or visit www.in.gov/atc.
RENTALS:
Will a company be providing any entertainment, equipment, portable restrooms, AV, stages, tents, or inflatables? □ Yes □ No IF YES:
Companies providing inflatables or other large-scale entertainment pieces must be approved by SBVPA. Once approved, the company must provide a certificate of insurance naming the City
of South Bend, South Bend Venues Parks & Arts, and the Park Board of Commissioners as Certificate Holder.
Final rental agreements with list of equipment from all hired companies must be submitted to SBVPA least 1 (one) week prior to the event.
NOTE: Staking of any tents or other equipment is NOT permitted in any South Bend park.
SECTION 4 - PUBLIC WORKS
Will the event require the closure of any streets or use of any public sidewalks?
□ No, the event will be entirely contained within the park (If no, continue to Section 5)
□ Yes, the event will need to close a street or use a public sidewalk
IF YES:
Approval for park use is contingent upon the Board of Public Works approval. An Application for Use of Public Right of Way for
Processions MUST be filled out FOUR (4) weeks prior to notice of event through the Board of Public Works:
Board of Public Works Phone: 574-235-9251
1316 County City Building Fax: 574-235-9171
227 West Jefferson Blvd. Email: publicwks@southbendin.gov
SECTION 5 - INSURANCE
A Certificate of Insurance (General Liability and Automobile Liability for $1,000,000.00 each), naming each of the following MUST be received 1 week prior to your event:
Is the event interested in purchasing insurance through the City of South Bend?
□ No, the event has its own insurance company that will provide insurance
□ Yes, the event would like to learn more about purchasing insurance through the City of South Bend
IF YES: A SBVPA staff member will contact the applicant to discuss insurance options through the City of South Bend.
SECTION 6 – EVENT LAYOUT
A rough event layout should be submitted within 1 (one) week of event to SBVPA. Event layouts can be created using Google Maps or other aerial view software, hand drawn, or created in
a design application. The event layout should include:
Outline of entire event venue including name of all streets/areas that are part of the venue and surrounding areas
Indication of any closed streets
The location of fencing, barriers and/or barricades. Indicate any removable fencing for emergency purposes.
Location of all stages, platforms, scaffolding, bleachers, grandstands, canopies, tents, portable toilets, booths, beer gardens, cooking areas, trash containers, dumpsters, and other
temporary structures
The location of generators and/or source of electricity
Placement of vehicles and/or trailers
Exit locations, including any emergency routes and emergency action plan.
SECTION 7 – INDEMNITY & HOLD HARLMESS AGREEMENT
City of South Bend Venues Parks & Arts Department Contract
Indemnity & Hold Harmless Agreement
Date: __________________________________________ Event Date: ________________________________________
Event Name: ___________________________________________________________________________________________
Organization: ___________________________________________________________________________________________
Applicant (Contact) Name: _______________________________________________________________________________
Applicant (Contact) Phone: ____________________________________ Alt. Phone: ______________________________
E-Mail: _________________________________________________________________________________________________
Address: ______________________________________________ City/State/Zip: __________________________________
Park Location: __________________________________________________________________________________________
Length of Event (Days/Times): ___________________________________________________________________________
Insurance Amount: 1 million dollars – one day insurance rider naming City of South Bend, Board of Park Commissioners and South Bend Venues Parks & Arts.
Waiver:
Organization Name: _________________________________________________________________ will release and discharge the City of South Bend and the Board of Park Commissioners, Parks Department,
and all organization volunteers from any and all liabilities due to any damage, injury, or loss of property.
I agree to this written contract and will abide by the rules set forth.
_____________________________________________________
Authorized Organizer Signature
_____________________________________________________
Printed Name and Title
Signed on this Date: ___________________________________ 20____________
City of South Bend Venues Parks & Arts Department Contract
Indemnity & Hold Harmless Agreement
Date: __________________________________________ Event Date: ________________________________________
Event Name: ___________________________________________________________________________________________
Organization: ___________________________________________________________________________________________
Applicant (Contact) Name: _______________________________________________________________________________
Applicant (Contact) Phone: ____________________________________ Alt. Phone: ______________________________
E-Mail: _________________________________________________________________________________________________
Address: ______________________________________________ City/State/Zip: __________________________________
Park Location: __________________________________________________________________________________________
Length of Event (Days/Times): ___________________________________________________________________________
Insurance Amount: 1 million dollars – one day insurance rider naming City of South Bend, Board of Park Commissioners and South Bend Venues Parks & Arts.
Waiver:
Organization Name: _________________________________________________________________ will release and discharge the City of South Bend and the Board of Park Commissioners, Parks Department,
and all organization volunteers from any and all liabilities due to any damage, injury, or loss of property.
I agree to this written contract and will abide by the rules set forth.
_____________________________________________________
Authorized Organizer Signature
_____________________________________________________
Printed Name and Title
Signed on this Date: ___________________________________ 20____________
SECTION 8 – REGULATIONS & AGREEMENT
The following procedures are those which must be followed to request the use of a city park for a special event outside of a pavilion or facility rental. This does not include reserving
a picnic site or renting a pavilion.
PARK BOARD: New events must make a formal presentation in front of the Park Board. The Board generally meets the third Monday of the month at the O'Brien Center at 5:00 pm. Returning
events do not need to appear before the Park Board unless there are changes (such as routes or park) or as requested by the Board.
INSURANCE: Proof of liability insurance must be provided at least one week in advance of the event. The city requires a $1,000,000 per event policy naming South Bend Venues Parks &
Arts, the Board of Park Commissioners, and the City of South Bend as additionally insured. Sample attached.
UTILITIES: Electricity is not guaranteed in any park. Water is turned off October through April (weather dependent).
RENTALS FROM SBVPA: Items requested for rental are not guaranteed. Rental is based on a first-come, first-served basis. See rental application for list and fees of available rental items.
STAKING: Staking of tents, bounce houses, or any other equipment is not permitted in any South Bend park.
POST-EVENT: Applicant assumes full responsibility of assuring the area will be cleaned up upon conclusion of the event. A post-event evaluation form may be completed and will focus on
items such as clean-up of park space, damages, and/or security concerns. Additional costs may be incurred, and/or future park use requests may be denied if park is left in poor condition
as determined by the Director of Facilities & Grounds.
NOISE ORDINANCE: The City of South Bend Noise Ordinance is in effect at all hours. Between the hours of 11:00 p.m. and 7:00 a.m. certain noises are particularly prohibited. These include
operating radio receiving sets, musical instruments, phonographs and other sound reproduction devices if audible fifty (50) feet away, as well as shouting, yelling, hooting, whistling,
or singing in the streets in a manner to disturb the peace (Municipal Code 13-57).
RESPONSIBILITY: If your event is not carried out in the manner in which you represent it to the Board of Park Commissioners, the event may be terminated immediately and can jeopardize
any future events held in South Bend Parks.
INDEMNIFY & HOLD HARMLESS: Applicant agrees to indemnify, defend and hold harmless the Civil City of South Bend, Indiana, and the Board of Park Commissioners from any liability, loss,
costs, damages or expenses, including attorney fees, which the Civil City of South Bend, may suffer or incur as a result of any claims or actions which may be made by any person, including
a participant in the event/activity, arising out of the approval of this request by the Board of Park Commissioners.
EXCLUSIVITY: The event is not guaranteed exclusive access to the park being requested. The event cannot restrict access to utilities to the public, including restrooms, playgrounds,
and water. Exclusive use of a parking lot is not guaranteed.
APPROVAL: All requests are processed on a first-come-first-serve basis, and no date will be confirmed until all materials, including payment, are submitted and approved. There is no
legal or binding commitment between the parties until you receive an official rental permit.
I have read and agree to the above rules and regulations and that this request may be denied based on any false or incomplete information. I have also received and read the pamphlet
with the City of South Bend Park Ordinances.
Date: ________________________
Applicant Signature: ___________________________________________________________
Printed Name: _________________________________________________________________