Schwenksville Special Events Permit Application

In order to ensure the safety of our residents and visitors, while also minimizing the impact of special events on the flow of pedestrians, traffic, and commerce within Schwenksville Borough, the following permit process must be completed by all persons and organizations who wish to host a special event within Schwenksville Borough.

Name of Applicant/Organization *

Main Contact Name *

Main Contact Mailing Address *

Main Contact Phone Number *

Main Contact E Mail Address *

example@example.com

Point of Contact Name *

Point of Contact Phone Number *

Name of Event *

Date of Event *

Date

Set Up Time *

Break Down Time *

TYPE OF EVENT *

Walk/Run Parade Block Party Festival Filming March Public Rally Other

Number of Participants

Number of Workers

DESCRIPTION OF EVENT *

LOCATION OF EVENT *

LIST ALL STREET CLOSURES (IF APPLICABLE)

Will your event have food vendors? *

YES NO

If "YES", you will need to provide a list of all food vendors, along with a copy of that vendor's Montgomery County Health Department license, or a temporary event license specific to this event. Food vendors must also provide a certificate of insurance naming "Borough of Schwenksville" as additionally insured.

Will your event have crafters, non-crafters, or information booths? *

YES NO

If yes, how many vendors or outside crafters will be attending?

Any non-food vendor will have to submit a waiver and release form to participate in the event.

SUBCONTRACTORS AND THIRD PARTY COMPANIES

List all sub-contractors and third party companies hired for this event. Examples include port-o- potties, trash removal, fencing, inflatables, etc

1)

2)

3)

4)

5)

All sub-contractors must provide a properly endorsed certficate of insurance naming "The Borough of Schwenksville" as additionally insured.

Upon receipt of the completed Special Event Permit Application, the Application will be reviewed by the Borough.

If approved, a Special Event Permit will be issued within 5 days of receipt of the Application.

The Certificates of Insurance shall be provided to the Borough prior to the Event.

Any fees payable are due prior to the Event.

The Borough reserves the right to withdraw the Special Event Permit if the Certificates of Insurance and fees payable are not received prior to the Event.

I/we acknowledge and agree to the terms and conditions set forth herein.

Signature of Applicant *

Clear

Date *

Date

Special Event Risk Release and Waiver of Liability

In consideration of the use of Schwenksville Borough property for an event in accordance with the Special Event Permit (the "Event"), I/we recognize and acknowledge that there may be certain risks of personal injury and property loss arising from the Event, and I/we agree to assume the full risk of any illnesses, injuries, including death, loss or damage of property from conducting the Event and use of any Borough property or facilities for the Event. I/we hereby specifically acknowledge, understand, and agree that the Borough does not sanitize, disinfect, clean or otherwise treat outdoor seating areas, pavilion, playground equipment and/or surfaces of any kind with which Event participants may come in contact. I/we agree to waive and relinquish all claims I/we may have as a result of hosting the Event. I/we agree and covenant to indemnify, defend, and hold harmless the Borough of Schwenksville and its officials, members, supervisors, employees, attomeys, successors and assigns against and from any loss, damage, cost. charge, expense. liability claims, demand or judgment of whatsoever kind or nature whether to persons or property, arising out of, resulting from or caused by, in whole, or part, any negligent act, error, omission or willful misconduct on part of Applicant, its agents, employees or subcontractors in connection with the Applicant pursuant to the Special Event Permit, including but not limited to, those in connection with loss of life, bodily injury. personal injury, damage to property. contamination or adverse effects on the environment, any liability for fines, fees, or penalties for violations of any statutes, ordinances, codes, rules, regulations or standards applicable to the activities or services provided by Applicant, its agents, employees or subcontractors at the Event (hereinafter' Acts and/or Omissions" In case of suit or cause of action brought against the Borough on the account of any Acts and/or Omissions, I/ we hereby agree and covenant to appear and assume the defense thereof and to pay all costs, charges, reasonable attorney fees and other expenses, and any and all judgments that may be incurred or obtained against the Borough. I/we agree to immediately notify Schwenksville Borough in writing of any claim or suit involving the Borough to which this release and waiver applies. The indemnification provisions have been mutually negotiated

Please read and agree to the following *

I HAVE READ THE ABOVE AND AGREE TO ABIDE BY ALL TERMS AND CONDITIONS SETFORTH IN THE RISK RELEASE AND WAIVER OF LIABILITY I HAVE READ THE ATTACHED USE OF BOROUGH FACILITIES POLICY AND RULES THAT APPLY AND AGREE TO THE TERMS, CONDITIONS, RESPONSIBILITIES AND UNDERSTANDINGS STATED THEREIN I UNDERSTAND THAT A CERTIFICATE OF INSURANCE NAMING SCHWENKSVILLE BOROUGH AND ITS EMPLOYEES, ELECTED AND APPOINTED OFFICIALS AS ADDITIONAL INSUREDS IS REQUIRED FOR USE OF THE COMMUNITY ROOM, PUBLIC TOILETS, MAIN STREET PLAZA AND MEETING ROOM. I UNDERSTAND THAT ALL MINORS MUST HAVE ADULT SUPERVISION AND THAT CONTACT INFORMATION FOR THE RESPONSIBLE ADULTS MUST BE PROVIDED TO THE BOROUGH.

Printed Name *

Signature *

Clear

Cell Phone *

Email *

example@example.com

BOROUGH OF SCHWENKSVILLE

SPECIAL EVENT PERMIT APPLICATION

SUBMITTING AN APPLICATION DOES NOT GRANT PERMISSION TO HOLD AN EVENT

APPLICATION MUST BE SUBMITTED 14 DAYS PRIOR TO THE EVENT