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Event Planning Form

City Clerk: (316) 775-4510 | City Manager: (316) 775-4510 | Community Development: (316) 775-4505 | Public Safety: (316) 775-4500 | Public Works: (316) 775-4507 City of Augusta | 113 East 6th Avenue | P.O. Box 489 | Augusta, KS 67010 City of Augusta Event Planning Form This form must be submitted at least 30 days prior to the event for review by City Departments and approval by the Governing Body. Event Name Event Date Start/End Times Location of Event Organization or Applicant Name Event Planner / Contact Person Address Phone Fax Contact On-call During Event Contact's Cell Phone What time will event set-up begin? What time will tear down be complete? Number of Event Staff Number of Spectators/ Attendees Total Please indicate if you are requesting permission to use one of the following city facilities (Some buildings and parks require fees and prior scheduling) Garvin Park Jim Brown Park Bill Reed Park Shryock Park Kerry Unrein Community Stage (Schedule/Fee) Gary W. Dryden Shelter Moyle Field Shryock Park Picnic Area (Schedule/Fee) Augusta Disc Golf Course Garvin Park Baseball Fields Will there be restrictions on parking? Yes No Will your event include food or retail sales? Yes No Will your event include a park or trail? Yes No Will your event include a parade or race? Yes No Will your event use tents/canopies? Yes No Will your event include fireworks or open fires? Yes No Other (Police Escort, Traffic Control, Barricades, Trash/Recycle Containers) Yes No If "Yes" to previous question, please provide details below. STREET CLOSURE Will your event require street closures? Yes No If "Yes" please list the streets you are requesting to close Have you contacted the residents / businesses affected by the street closure? If not, you will need to contact them after receiving approval from the Governing Body. Yes No N/A Did you have any issues when you contacted the residents / businesses about the street closure? Yes No N/A If "Yes" please explain **If you are going to use paint to mark routes for runs/walks/bike rides on City streets, IT MUST be water soluble paint.** Site Plan or Sketch (please attach to this form): If you plan to have a parade or event involving the closure of streets, please provide a sketch of the parade route or sketch of the streets that you are requesting be closed for your event. Please provide a detailed description of your event: *The City of Augusta will bill race organizers for police officer's overtime rate plus fringe benefits for each additional officer required as a result of an event to be held within the city. If no additional officers are required above normal shift levels, no charges will be assessed.* **The event organizers agree to secure and maintain event liability insurance in a sum not less than $1 million and to provide a certificate of insurance coverage to the City PRIOR to the event. The City of Augusta shall be named as an "Additional Insured" for the event on the certificate.** ***Under no circumstances are vehicles allowed in any location of any park - except for designated parking areas - without prior consent granted at the time the event is approved by the Governing Body. Failure to abide by this request may result in a loss of privilege to use the park system for future events.*** I, the undersigned, certify the statements and information included in this event form are true, accurate and complete to the best of my knowledge and belief. Event Coordinator Signature Date Please return this application and all supporting documents to: Augusta City Hall 113 East 6th Avenue - P.O. Box 489 Augusta, KS 67010 Fax: (316) 775-4566 E-mail: Approved Initials Date