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2022 Special Event Permit Application **To send this form electronically; the file name must be saved as SEPA-Application.PDF Name of Special Event / Tournament Requested date(s) with start and end times of setup, event, & tear down If this is an annual event, what is the anticipated date(s) for next year? Expected Attendance Max attendance at one time Special Event Sponsor / Organization Mailing Address City State Zip Primary Contact Name Title Email Phone Alternate Contact Name Email Phone On-site Point of Contact (if different than applicant): Name Phone 1 ---PAGE BREAK--- Location(s) Requested Check all that apply Southridge Sports & Events Complex Entire Pavilion Multi-Court Meeting Room Pavilion Cafe Plaza South Plaza North Sports Field(s) Walking Path Parking Lot South Parking Lot North Columbia Park Bandshell Riverfront East Riverfront West Memorial East Memorial West 20 Acres Fishing Pond Lampson Pits Walking Path Other Space Eastgate Park Eastgate Sport Fields Hanson Park Keewaydin Park Lawrence Scott Park Other Baseball/Softball Fields Civic Fields Lawrence Scott Fields Southridge Fields Type of event (check all that apply): Car Show Fundraiser Picnic Walk/Run/Cycling Concert/Performing Arts Sporting Activity Other If your event is a tournament, please answer the complete this section; otherwise skip to next section. Sport: Type of Tournament: Estimated # of Teams: Age Divisions: Entry Fee: Requests: Field Painting Outfield Inner Fencing Hanging Banners 2 ---PAGE BREAK--- Event Details Provide a detailed description of your event. Will any type of structure be used? Check all that apply. Temporary Stage Canopy (10x10') Pipe & Drapes Fence Tent (>10x10') Outdoor Lighting Display Vehicle Portable Sink Portable Restroom Grill / Cooking Appliance Generator Theater Screens The following activities are considered "higher risk" and may require higher limits of insurance. Please check all that apply: Animals: Domestic or Exotic Drones Fireworks / Pyrotechnics Inflatables: bounce houses, slides, etc. Mechanical Amusement Rides Swimming Wall-Climbing Watercraft used Water-Slides Aircraft / Helicopter Other 3 ---PAGE BREAK--- Features of your Event Is your event open to the public? No, my event is a private, by invitation only, event. Yes, my event is open to the public. Will admission fees be collected (check all that apply)? No, my event is free to attend. Yes, admission fees will be collected at the event. Yes, tickets will be sold in advance. I will complete an Admissions Tax Return immediately following the final event date and submit the completed forms to Customer Service at City Hall. Will food be provided at your event? There is no food sold and/or consumed at my event. The food being consumed at this event is a closed picnic, no sale of food, no provision of food to the public. Yes. I will be responsible for ensuring my vendors have obtained all of the necessary food service permits or exemptions, and evidence of liability insurance with products/ completed operations coverage. Will alcohol be sold/consumed at your event? There is no alcohol sold/consumed at my event. Yes, I will obtain the required Special Occasion License from the Washington State Liquor and Cannabis Board for this event and the required additional liquor liability insurance, and I will provide the Special Occasion License and Insurance documentation to the City at least 30 days prior to the event. (Some permits take up to 90 days to process by the Will your event have amplified sound? No, my event will not have amplified sound. Yes, my event will have recorded music/sounds. Yes, my event will have live music/performances and I will provide a noise monitor. 4 ---PAGE BREAK--- Will streets, footpaths, bridges, limited access areas be closed? No Yes, and I will submit the completed Parade, Demonstration, Street Closure Permit Application and fee to the City of Kennewick at least 30 days prior to my event. Will any vehicles be driven onto City Property? Choose all that apply. No. All vehicles will remain in designated parking lots/stalls. Yes, vehicles will be driven onto grass or concrete for loading/unloading purposes. Yes, vehicles will be driven onto grass for attendee parking purposes. Will donations be collected? No Yes, in conformance with KMC Chapter 6.23, provided the proceeds are used for the sole purpose of conducting the permitted event and necessary expenses incident, thereto. Will there be any type of raffle at the event? No Yes, and I will comply with the provisions of KMC Chapter 3.6 - Gambling Tax and the Washington State Gambling Commission. Will your event include on-site overnight camping? No, there will be no overnight camping at my event. Yes, one overnight security trailer will be present at my event. Yes, overnight camping will be offered to staff, volunteers, and/or the public. I will complete the City of Kennewick Overnight Camping Fee Assessment form and return it to the Special Events Office within 48 hours after my event. 6 ---PAGE BREAK--- Please Initial: I have read the Special Events Permit Guide and understand the requirements for my event: This application is fully completed and all activities associated with the event have been fully disclosed: The City of Kennewick may revoke a permit and/or stop use in progress if the User fails to comply with any Federal and/or State laws, City ordinances, and the terms of this permit. The City of Kennewick may also revoke a permit and/or stop a use in progress if the user fails to secure a necessary permit, disregards a lawful order of an authorized representative of the City of Kennewick, or engages in activity that may cause injury to the public or damage to the premises. I agree to pay any fees associated with this request at least 30 days prior to my event. Cancellations are to be received by the Special Events Office, in writing, at least 30 days prior to the event to be eligible for a refund. Hold Harmless: I agree to defend, indemnify and hold harmless the City, its officers, officials, employees, and volunteers from and against any and all claims, suits, actions, or liabilities for injury or death of any person, or for loss or damage to property, which arises out of the use of the Premises or from any activity, work or thing done, permitted or suffered by me or the organization I represent in or about the Premises, except only such injury or damage as shall have been occasioned by the sole negligence of the City. I further state that I am 18 years of age or older, am legally competent to sign this agreement, and am authorized on behalf of the organization I represent to sign this agreement. I understand these terms are contractual and not a mere recital, and that I have signed this document of my own free act. I make application to the City of Kennewick for the use of the facility and/or property described above. I certify this information is correct. I agree to exercise care and safety in use of the facility and property, to hold harmless the City of Kennewick from all liability and medical expenses resulting from the use of the facility/property, and agree to adhere to the General Park rules of the City of Kennewick. Print Name Date Signature 7