K-2 - Special Events Application - Girls on the Run 5K

Event Description: Girls On The Run 5K Name of Applicant: Christina Hamarstrom Phone: 319-541-4981 Location of Event: Clear Creek Trail Date of Event: 11/06/21 Time of Event: 0900 Estimated Number of Participants: 30 Person Responsible for Monitoring Event: Christina Hamarstrom Plan for Restroom Facilities: Porta potty / baseball field Plan for Police Protection: N/A Describe Clean Up Plans: Coaches & girls will clean after run Parking Plan: Auxiliary field parking lot Description of Mechanical or Electronic Equipment to be used for Sound Amplification: Number and Type of Vehicles Including Bicycles to be Used in Event: Signs along field to mark miles Temporary Signage Request: Special Circumstances Requested from City: Proof of Insurance Attached: □ or I certify that I am the person authorized to act on behalf of the event to request this permit and understand and agree to pay on behalf of the City all sums which the City shall be obligated to pay by reason of any liability imposed upon the City for damages of any kind resulting from use of public property and the public right of way, whether sustained by any person or persons, caused by accident or otherwise and shall defend as its own expense and on behalf of the City any claim against the City arising out of the use of public property and the public right of way and agree to follow all other ordinances that shall pertain including Ordinance 2006-277, City of Tiffin, Iowa. I understand that I will not erect any temporary signage for the event prior to City Approval of signage. [Signature] 9/20/21 Date For City Use: Authorized City Signature Date Copy to Applicant _____ Johnson Co. Sheriff Notified _____ Fees Collected _____ Public Works Notified _____ Tiffin Fire Department Notified _____ Council Approval _____