Special Event Application

Special Event Application
Event Name*
Event Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Event Contact Name*

First NameLast Name
Event Contact Phone Number*
Please enter a valid phone number.
Event Contact Email*
example@example.com
Event Start Date*

MonthDayYear
Date
Event Start Time*

Hour Minutes

AM/PM Option
Event End Date*

MonthDayYear
Date
Event End Time*

Hour Minutes

AM/PM Option
Number of Total Participants*
Overall Event Profile

Check all that apply
Nature of Event*

Concert / Music FestivalExhibit / Trade ShowBicycle /Foot Race / ParadeAthletic / Sporting EventAgricultural / Farmers MarketCarnival / Fair / Circus / Haunted HouseMotor SportAviationPolitical RallyMarine EventPyrotechnic DisplayBeer/Wine TastingMotion PictureWedding
If your event is Pyrotechnics/Fireworks, please complete the Fireworks Display Application and upload it below.
Venue

IndoorsOutdoorsParking / Traffic AccessFestival Seating / StandingTables & ChairsHeating ProvidedGenerator Provided
Tents (larger than 20x20 feet)

YesNo
If yes, please review the Tent Requirements.
Food and Beverage

Catered / Prepared Off-SiteBarbeque / Grill On-SiteDeep Fryer On-SiteRanges On-SiteAlcohol Served
*Safety Provisions*

Check all that Apply
Security

Event StaffPrivate SecurityLaw Enforcement
Please review the Event Medical Plan Requirements.
Event Medical Plan Requirements

Event NameEvent on-site medical contact name and phone numberEvent organizer name and phone numberDate(s) of eventTime(s) of event, each dayEvent overview and planned activitiesExpect daily attendanceEvent locationNumber and types of event medical staffDescription of on-site medical treatment facilities, equipment and staffing capabilities (first aid, BLS, ALS, RN, MD)Length of time for event medical staff to reach an injured/sick person located at furthest point of eventDescription of on-site emergency communications capabilities (cell phone, radio, satellite phone)Confirmation of cellular phone signal throughout event area and communications plan for areas with no cellular device)Helicopter access and landing zone location location/coordinates (minimum 100' x 100' clear area that is flat and free of trees and bushes)Designated ambulance staging locations or ambulance rendezvous pointsDescribe how injured/sick persons will be transported to ambulance staging area(s) by event medical staff (both ambulatory and non-ambulatory)Inclement weather plan (lightning, hail, smoke, snow)Emergency medical procedures for event staff (basic first aid vs. major medical/911 thresholds)Describe how event participants will be notified of emergency procedures during eventPlan for emergency evacuation of the Special EventEvent map (including venue layout, event medical location(s), ambulance access, staging area(s) and rendezvous points, helicopter landing zones)
Upload Event Medical Plan here*

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Is an ambulance stand-by required?

YesNo
If yes, please fill out the Fire Engine/Ambulance Standby Service Request Application and upload it below.
Upload your Fire Engine/Ambulance Standby Service Request Application and/or your Fireworks Display Application here.

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Additional Documents (Optional)

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Additional Comments
I declare under penalty of perjury, to the best of my knowledge and beliefs, the responses made herein are true and correct.
California Fire Code 2022 Chapter 31 Tents/Special Events
RELEASE OF LIABILITY AND INDEMNIFICATION FORM

TO THE FULLEST EXTENT ALLOWED BY LAW, THE APPLICANT (SPONSOR, PROMOTER, AND LAND OWNER) SHALL INDEMNIFY, DEFEND, AND HOLD HARMLESS THE TRUCKEE FIRE PROTECTION DISTRICT, AND ITS OFFICERS, AGENTS, ELECTED AND APPOINTED OFFICIALS, AND EMPLOYEES (“DISTRICT INDEMNITEES”), FROM AND AGAINST ANY AND ALL CAUSES OF ACTION, CLAIMS, LIABILITIES, OBLIGATIONS, JUDGEMENTS, OR DAMAGES, INCLUDING REASONABLE ATTORNEYS’ FEES AND COSTS OF LITIGATION (“CLAIMS”), DIRECTLY OR INDIRECTLY ARISING OUT OF THE APPLICANT’S PERFORMANCE OF ITS OBLIGATIONS, OR EXERCISE OF ITS RIGHTS, UNDER THIS SPECIAL EVENT PERMIT OR OUT OF THE OPERATIONS CONDUCTED BY THE APPLICANT, INCLUDING THE DISTRICT’S PASSIVE NEGLIGENCE, EXCEPT FOR SUCH LOSS OR DAMAGE ARISING FROM THE SOLE NEGLIGENCE OR WILLFUL MISCONDUCT OF THE DISTRICT. IN THE EVENT THE DISTRICT INDEMNITEES ARE MADE A PARTY TO ANY ACTION, LAWSUIT, OR OTHER ADVERSARIAL PROCEEDING ARISING FROM THE APPLICANT’S PERFORMANCE OF THE AGREEMENT THE APPLICANT SHALL PROVIDE A DEFENSE TO THE DISTRICT INDEMNITEES OR AT THE DISTRICT’S OPTION REIMBURSE THE DISTRICT INDEMNITEES THEIR COSTS OF DEFENSE, INCLUDING REASONABLE ATTORNEY’S FEES, INCURRED IN DEFENSE OF SUCH CLAIMS.
I have read and agree to the release of liability and indemnification form.
Signature*

Clear
Name

First NameLast Name
Date*

MonthDayYear
Date
My Products*
prevnext( X )
Special Event Plan Review Fee
$144.15

503c/501c Exemption (you must be a 503c/501c)
$ Free

Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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Special Event Application

Overall Event Profile

*Safety Provisions*

Safety Provisions