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Special Event Application

2. Name of Event*
   If the event doesn’t have an official title such as the “March of Dimes Walkathon”, enter a generic description such as “Fun Run for Red Cross”, “Easter Egg Hunt”, etc.
4. Date(s) of Event*
6. Time of Event*
8. Type of Event

   1. Public Gathering
   2. Walk or Run
   3. Private Gathering
   4. Professional Filming
   5. Parade
   6. Other
10. Type of Event - if not listed above
12. Location of Event*
    -- Select One --Angel Street Soccer ComplexBarnes ParkBishops FieldGailey ParkHeritage ParkPioneer ParkPonds Park NorthPonds Park SouthWilderness Park

    Location or Starting Point (include map): Include an off-street parking plan and site map showing planned location of booths, activities, etc. Reservations of pavilions are first come first serve and must be completed separate from this application at www.kaysvillerec.com. · There must be adequate off-street parking to accommodate the special event. If the event generates more vehicles than available parking, the event may not be permitted. · Any event using a State road (SR-273) must obtain a permit from the Utah Department of Transportation. · Events which block public streets/sidewalks cannot restrict emergency access. · Course for runs, walks, marches and all other events using Kaysville City Streets, Parks, etc. must include a map with the route clearly indicated by using a black marker so the map can be copied for distribution to affected city departments. · Maps must indicate which streets and/or sidewalks are to be used, water stations, site plan, etc. Note that no permanent markings can be made on city properties, streets and/or sidewalks. Course directions may only be marked using temporary signage. · Applications for parades must include a map that indicates the route, staging and disbanding areas and an estimate of the number of entrants, floats, etc.
14. Describe Any assistance required from Kaysville City departments (Police, Fire, Parks & Recreation, etc.). Charges for City services may apply.
    List any special assistance you require such as traffic control for crossing streets during a walkathon, access to electricity, extra dumpsters, etc. City may not provide all services requested. Depending on the size of the event, the City may require additional outside or private services to be provided, per the City’s approval of personnel. Charges for City services may apply. Note: Due to the nature of the event, those expected to attend the event, others who may be present, and/or the location of the event, the city may determine it to be in the best interests of the health, safety and welfare of the public to require the presence of public safety personnel at an additional cost to the applicant.
16. Previous Events
    List previous events sponsored by applicant that are similar to the one being applied for. List names, locations, dates, and contacts.
18. Set Up*
    Day of week; Date; Time
19. Take Down*
    Day of week; Date; Time
20. Alcohol*

    1. Yes
    2. No

    I understand alcohol is NOT permitted on ANY City properties
22. Estimated Attendance*
    Approximate number of participants and/or spectators expected at the event. If expected attendance is 1,000 or more, which continues for two or more hours per day, a temporary mass gathering permit is required by Davis County Health Department. daviscountyutah.gov. For events with attendees at one given time during the event is over 1,500 the applicant must have City Council approval. If mass gathering permit is required, Kaysville City will delay issuing final approval until the mass gathering permit is obtained.
23. Concession or Food Truck Privileges*

    1. Yes
    2. No

    If yes, all Health Department rules and regulations must be followed. Proof of compliance required no later than 2 weeks prior to event start. Barnes Sportsplex not applicable. A Temporary Food Service Permit must be obtained in any instance where food is prepared for sale to or consumption by the public. Contact Davis County Health Department, 99 S. Main, Farmington, UT 84025, Phone (801) 451-3296 to obtain the permit. Barnes Sportsplex not applicable.
25. Organization Name*
    Title of organization or the event name if not affiliated with an organization.
27. Applicant Name*
    Name of the person that the Coordinating Department may contact in case of questions or if an emergency situation occurs. Also include a secondary or alternate contact person who may be reached if the first person is unavailable.
28. Email Address*
30. Address*
32. City*
33. State*
34. Zip Code*
36. Phone Number*
37. Cell Number*
39. Liability Insurance Information (required)*
    Insurance Information: All events open to the public require a certificate of insurance for $1,000,000.00 commercial general liability coverage with Kaysville City Corporation named as the certificate holder and as additional insured. This is a standard request and most insurance companies supply the certificate at little or no charge. If you cannot obtain a certificate, Special Event Insurance may be purchased.
41. Please check all items that you intend to include in your event. Provide a detailed explanation for each item checked. Fees may apply for City provided services. If you have questions, please contact the Coordinating Department.*

    1. Admission to be charged
    2. Animals (refer to City code)
    3. Barricades
    4. Bicycles
    5. Bleachers
    6. Booths—Vendors handing out items
    7. Booths—Vendors selling
    8. Canopies or tents
    9. Command Post
    10. Crowd control
    11. Drawing or raffle
    12. Electrical requirements
    13. Fencing or scaffolding
    14. First Aid Station
    15. Food—catered
    16. Food—given away
    17. Food—prepared on site
    18. Helicopter
    19. Hot Air Balloons
    20. Helium Balloons
    21. Live Entertainment
    22. Mechanical Rides
    23. Music—amplification
    24. PA system
    25. Parade
    26. Park reservation
    27. Portable sanitary units
    28. Propane gas
    29. Road closure
    30. Security
    31. Security—Private
    32. Sidewalk usage
    33. Sports competition
    34. Stage
    35. Street usage
    36. Traffic control
    37. Trash cans
    38. Vehicles
    39. Other - see below

    If additional information about any of the items is required or if there are restrictions associated with any of the items checked, you will be contacted.
43. Explanation of items checked above*
45. Fees - pay link will be emailed to applicants*

    1. I agree
    2. I disagree

    A $20.00 application fee is required. In addition, all applicable park and reservation fees will be charge and must be paid before the reservation can be confirmed. Kaysville City may assess a cleaning fee, determined by the type of event, number of participants, etc.
46. The following enclosure(s) will be emailed to recreation@kaysvillecity.com*

    1. Map
    2. Liability Insurance
    3. Description of structures
    4. Davis County Mass Gather Permit
    5. Other
48. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature. 3) you may still be required to provide a traditional signature at a later date, and 4) I agree to carry out this event in full compliance with Kaysville City policies and codes. In addition I agree to carry out this event in full compliance with the requirements of outside organizations, as applicable. I agree to carry this application with me at all times during the event.

    1. I agree.
50. Electronic Signature*
Leave This Blank:


52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit

* indicates a required field