K-3 - Special Events Application - Movies in the Park - Infuse Church

Event Description: May & June & July - Movies in the Park Name of Applicant: Gina Smothers Phone: 248-891-7545 Location of Event: Tiffin Soccer Fields Date of Event: 5/21/2022 Time of Event: 6pm-11pm Estimated Number of Participants: 400+ people Person Responsible for Monitoring Event: Taylor Getting Plan for Restroom Facilities: Porta Potty Plan for Police Protection: N/A Describe Clean Up Plans: Volunteer teams will clean up the park after the event Parking Plan: Drive-In Style Park on the grass Description of Mechanical or Electronic Equipment to be used for Sound Amplification: Two 1500 W speakers Number and Type of Vehicles Including Bicycles to be Used in Event: none Temporary Signage Request: N/A Special Circumstances Requested from City: Power from the city building and this also includes the dates 6/18/2022 & 7/16/2022 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 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 _____