City of Wildwood Special Event Application Form

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City of Wildwood

Special Event Application Form

2012

Date of Event: _____________________________________ Date of Application: ______________________________

Name of Event: ____________________________________________________________________________________________
Type of Event (check one)  Beach Event  Foot/Bike Race  Walk-a-thon  Boardwalk  Car Show
 Festival ( 1 day  multi day)  Film  Craft Show  Parade

 Block Party Other: ________________

The City of Wildwood requires all organizations, corporations and/or individuals planning to stage an event to file an official application with the office of the Board of Commissioners.
The Mayor and/or Board of Commissioners have sole authority over the issuance of all special event permits.
Please refer to Ordinance 599-03 and 799-10, which detail the responsibilities of applicants and the City of Wildwood, before completing your application.
Any use of the words “City of Wildwood” in event literature/advertising must be approved by the governing body.
DISCLAIMER: All ordinances of the City of Wildwood and statutes of the State of New Jersey apply. It is the responsibility of the event organizers to determine what laws apply to a particular event. Failure of the City to list a specific law, code section or ordinance herein shall not be a defense to a violation thereof.
In addition to the filing of an event application, applicants may be required to attend a meeting with the appropriate City Officials for review of the application. A second meeting, approximately one week prior to the date of the event, may also be required to accommodate last minute changes and additions.

The City of Wildwood wishes you success and is ready to assist you in any way.

APPLICANT INFORMATION

Name of Organization: _____________________________________________________________________________

Address of Organization: ____________________________________________________________________________

__________________________________________________________________________________________________

Phone _________________ Fax _________________ Cell _________________ Email __________________________
Point of Contact: ____________________________________________ Phone: ________________________________
Purpose of Organization: ____________________________________________________________________________
Is your organization tax exempt? ____________________ Tax ID __________________________________________
Is this a non-profit event? _____________ NJ Registered Charitable Organization # ___________________________
Has funding been secured for this event?  Yes  No
If yes, please provide primary sources of funding. Indicate whether GWTIDA or other public funds are being used. If no, please provide detailed information on projected funding sources.

__________________________________________________________________________________________________

ORGANIZATION INFORMATION

1) List the names and titles of the authorized and responsible heads of your organization. Or attach copy of documentation showing same.

^{Name of President / Leader}	^Title
^Address		^Email
^{City / State / Zip}
^{Home Phone}	^{Work / Cell Phone (identify which)}

^{Name of Vice President}	^Title
^Address		^Email
^{City / State / Zip}
^{Home Phone}	^{Work / Cell Phone (identify which)}

^{Name of Treasurer}	^Title
^Address		^Email
^{City / State / Zip}
^{Home Phone}	^{Work / Cell Phone (identify which)}

^{Name of Secretary}	^Title
^Address		^Email
^{City / State / Zip}
^{Home Phone}	^{Work / Cell Phone (identify which)}

2) Information about person applying for the permit on behalf of the organization:

^{Name of Permit Applicant}	^Title
^Address		^Email
^{City / State / Zip}
^{Home Phone}	^{Work / Cell Phone (identify which)}

EVENT INFORMATION

1) Official Name of Event: _______________________________________________________________

____________________________________________________________________________________
2) Purpose of Event: ____________________________________________________________________

____________________________________________________________________________________

3) Specific Location of Event: ____________________________________________________________

(Name/Address, Park or Facility)
4) Will alcohol be served or sold by event organizers or others?  Yes  No

(ABC Permit may be required. Glass bottles and cans are prohibited at event sites.)
If yes, describe in detail (e.g. merchant sales/vendor sales/organization sales). _________________

____________________________________________________________________________________

5) Describe Event Activities (Include copy of program schedules): ______________________________

____________________________________________________________________________________

____________________________________________________________________________________
6) Dates and time of Event: (use additional paper if necessary)

Dates and Times Events
Set-up/Assembly:	Date:		Hours:
	Date:		Hours:
	Date:		Hours:

Event Operation:	Date:	Start:		Finish:
	Date:	Start:		Finish:
	Date:	Start:		Finish:

Dismantling/Disbanding:	Date:		Hours:
	Date:		Hours:
	Date:		Hours:

6a) Rain Dates: _________________________________________________________________________

7) I hereby confirm that I will notify all persons requiring a permit in connection with this Special Event request of the fee structure detailed in the section entitled “Fire & Housing Bureau.”
_______________________________________ ________________________________________

Signature of Applicant Date

THIS SECTION FOR MULTIPLE DAY EVENTS
1) Will the event require the site to remain in place overnight or will the site be broken down each night (partially or completely)? Explain: ____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________
2) If the site is to remain in place overnight, how do you plan to secure it? _______________________

____________________________________________________________________________________

____________________________________________________________________________________

Note: Events will require a detailed site plan.

INSURANCE REQUIREMENTS

ATTACH COPY OF CERTIFICATE OF INSURANCE

Name of Insured: __________________________________________________________________________
Name of Insurance Company: _______________________________________________________________
Policy Number: ____________________________________________________________________________
Limits of Liability: _________________________________________________________________________
See attached Addendum for insurance requirements.
Applicant certifies that they have or will obtain and maintain liability insurance and property damage insurance and, further, to list the City of Wildwood as an additional insured under said policy, arising out of this special event. Said insurance coverage shall be primary and any coverage of the City shall be excess. Proof of such insurance shall be delivered to the City Clerk no less than twenty (20) days prior to the day of the special event. Evidence of financial responsibility is outlined in the following “Certificate of Insurance” page.
******

APPLICANT SIGNATURE

(MUST BE NOTARIZED)
I, ___________________________________________, the undersigned, state that I am the duly authorized representative of the _______________________________________________________________________ and the information provided in this application is correct to the best of my knowledge. I understand that some of the information is preliminary in nature and I will provide updated information as it becomes available. I further agree to abide by changes made to the proposed event as indicated when so granted. I further understand that acceptance of this application by the city of Wildwood does not constitute authorization to conduct this Special Event.
____________________________________________________________

Signature of Individual Applicant

____________________________________________________________

Authorized Signature on behalf of Organization

Sworn and subscribed to before me

This _____ day of ________________, 2012
_____________________________________
CERTIFICATE OF INSURANCE

Evidence of financial responsibility from event chairperson, organization and others with whom the City of Wildwood does business is required. Evidence should be in the form of a document that is issued by an insurance company or their authorized representative, which spells out the insurance coverage in force at the dates and time the Special Event will occur. It does not serve as a binder and does not confer rights upon the holder. The policy must be current and not expire before or on the date(s) of the event.
The Mayor and/or Board of Commissioners may refuse to grant the use of permission to execute the Special Event whenever in their judgment there is good reason why permission should be refused. They shall not be required to give a reason for such refusal.
Individuals - Block Parties or any other oriented parties.
Non-Profit/Charitable Groups - Civic Groups, Social Groups, Support Groups or any other group that does not gain profit.
Commercial Rental - Any organization that is for profit (i.e., Associations, Corporations etc.).
1) INDIVIDUALS:

a. General Liability Limit $100,000.00

Evidence that the individual has personal liability insurance in force is required to use any City of Wildwood property or facility. This would be in the form of Homeowners, Condo or Tenant’s policy where the personal liability coverage is included along with other coverage for the individual. A copy of the policy needs to be kept on file with the Special Event Application as evidence of coverage.
2) NON-PROFIT/CHARITABLE GROUPS:

a. General Liability Limit $300,000.00

b. City of Wildwood named as “Additional Insured”
c. Executed Hold Harmless Agreement required with Special Event Applications. The Special Event shall not be allowed to occur or use the City of Wildwood until it has obtained the insurance required under this contract. All coverage shall be with insurance carriers licensed and admitted to do business in the State of New Jersey and acceptable to the City of Wildwood. If the organization or individual contracts with a vendor, evidence of adequate insurance coverage also need to be secured from them.
3) COMMERCIAL (FOR PROFIT) GROUPS

a. Commercial General Liability Limit $1,000,000.00

Combined Single Limit of Liability for Bodily Injury and Property Damage
b. City of Wildwood named as “Additional Insured”
c. Executed Hold Harmless Agreement required with Special Event Applications. The Special Event shall not be allowed to occur or use the City of Wildwood until it has obtained the insurance required under this contract. All coverage shall be with insurance carriers licensed and admitted to do business in the State of New Jersey and acceptable to the City of Wildwood. If the organization or individual contracts with a vendor, evidence of adequate insurance coverage also needs to be secured from them.
INDEMNIFICATION AND RELEASE AGREEMENT

This Agreement between ___________________________________________________ (I, Me) located at _____________________________________________ and the City of Wildwood, a municipal corporation of the State of New Jersey, located at 4400 New Jersey Avenue, Wildwood, NJ 08260 is entered into this _____ day of ____________________, 2012.

W I T N E S S E T H
In accordance with provisions of the Revised General Ordinance 2-34, the description of the event and promises made in my application, in consideration for my being allowed to use City property and facilities and the granting of a Permit to hold the ____________________________________________________________ (the Event”) on _________________________ (or rain date _________________________), I do hereby covenant and agree that:
1) I hereby WAIVE and RELEASE the City of Wildwood from any and all claims which I may have or which may hereafter accrue to me as a result of my use of any City property and facilities in connection with the Event. This specifically includes, but is not limited to, a waiver and release for any injury or damages I suffer through (1) negligence or omission of City; (2) the condition of any public property; or (3) some other cause, including an act or omission by a participant of the Event.
2) I will INDEMNIFY, HOLD HARMLESS and DEFEND the City from and against any and all claims which arise in connection with the Event or my use of City property. This includes any claims made by, or involving, other participants of the Event.
3) I will be responsible for and pay the costs of repair or replacement for any damage(s) or Claims to City and/or City property occurring or arising out of the Event.
4) All of my employees, my agents and other participants have been properly instructed concerning the conditions of the permits I have been granted, have any necessary drivers or other licenses and will obey the directions of law enforcement officials.
5) The Permit is revocable and this Agreement is voidable by the City at any time if the conditions of the Permit or this Agreement are violated or for health or safety reasons.
6) I shall be subject to the conditions and terms of this Agreement and the Events Permit for as long as I use any City property even if such use is before or after the Event. This specifically includes set-up and break-down times.
7) The following terms shall have the following meanings unless otherwise indicated:

a. "City" means the City of Wildwood, and all other governmental entities, their officers, employees and agents together or individually.

b. "Claims" means causes of action, claims, costs, debts, demands, expenses, fines, interest, legal fees, liability, penalties, rights to sue or suits, including but not limited to those arising from damages to persons or property, death, injury, and theft.

c. "Event" includes the event and any related activities.

d. "I" or "me" means any of my officers, employees, agents or others participating with me in the Event, together or individually.
8) This Agreement is given to the City in connection with a Special Events Permit and no employer/employee, agency, lessor/leasee, conveyance of land or estate or other contractual relationship exists between the parties, or shall City be deemed a sponsor of the Event.
The undersigned represents and warrants that he or she has full authority to enter into this Agreement on behalf of Applicant, that Applicant has entered into this Agreement voluntarily after reading it and understands all its terms.
By: _______________________________________ ________________________________________

Name Witness

PARADES
1) Proposed Parade Route (attach map): ___________________________________________________

____________________________________________________________________________________

2) Starting Location (identify on map): ____________________________________________________

____________________________________________________________________________________

3) Ending Location (identify on map): _____________________________________________________

____________________________________________________________________________________

4) Assembly Area (identify on map): ______________________________________________________

____________________________________________________________________________________

5) Disbanding Area (identify on map): ____________________________________________________

____________________________________________________________________________________

6) Location of Reviewing Stand (identify on map): ___________________________________________

____________________________________________________________________________________

7) Location of Judging Stand (identify on map): _____________________________________________

____________________________________________________________________________________

8) Number of Participants: _______________________________________________________________
9) Number of Bands / Musical Units: _____________________________________________________
10) Number of Floats: ___________________________________________________________________

(Note: Certain height restrictions may apply due to overhead wires)
11) Number of Animals: _________________________________________________________________
12) Number of Cars / Trucks: _____________________________________________________________
13) Number of Buses: ____________________________________________________________________
a. Will you require Off-Site Bus Parking?  Yes  No
14) All Parades must have at least one designated Parade Marshall on location during assembly, operation and disbanding.

^{Name of Parade Marshall}	^Title
^Address		^E-MAIL
^{City / State / Zip}
^{Home Phone}	^{Work / Cell Phone (identify which)}

PARADES (continued)

15) Rain Date or Delayed Starting Time: ____________________________________________________

____________________________________________________________________________________
16) Special Guests (i.e., Governor, etc.): ____________________________________________________

____________________________________________________________________________________

17) Have Emergency Medical Service provisions been made?  Yes  No
18) How do you plan to handle Traffic Control along the parade route? __________________________

____________________________________________________________________________________

FESTIVALS

1) Is the applicant solely responsible for the operation of the event?  Yes  No

2) If an event management company is contracted to handle the event, please provide the following information:
Company Name: ____________________________________________________________________
Address: ___________________________________________________________________________
City/State/Zip: _____________________________________________________________________
Contact Person: ____________________________ Phone: _________________________________
Portion/s of event for which the company is responsible: ___________________________________

____________________________________________________________________________________

3) Location of Festival (list any street closing): ______________________________________________

____________________________________________________________________________________

4) Number of Non-Food Vendor Spaces: ___________________________________________________
5) Number of Food Vendor Spaces: _______________________________________________________
6) Attach a list of Vendors and Contact Numbers. A fully updated list must be turned in two weeks prior to event. Food Vendors must meet the requirements of the CMC Board of Health.
7) Location of Stages / Performance Areas: ________________________________________________

____________________________________________________________________________________

Who will be providing these stages? ____________________________________________________
8) Type of Entertainment / Music: ________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

(Attach copy of program schedule; it may be submitted in draft version. A final version must be turned in two weeks prior to event.)
9) Will alcoholic beverages be served:  Yes  No

(ABC Permit may be required. Glass bottles and cans are prohibited from being served at event sites.)
10) Attach a preliminary site plan of entire area, including port-a-potties, vendors, stage, etc.

(Site plan updates should be submitted as needed with final site plan, reflecting the current year information, submitted one month prior to event.)
11) Special Guests (i.e., Governor, etc.): ____________________________________________________

____________________________________________________________________________________

12) Have Emergency Medical Service provisions been made?  Yes  No

BIKE / FOOT RACES / WALK-A-THON

Name of Race: ______________________________________________________________________

Purpose of Race: _____________________________________________________________________

Entrance Fee Charged:  Yes  No Amount: $__________________________

Beneficiary: _________________________________________________________________________

Race Distance: ______________________________________________________________________

Number of Participants: _______________________________________________________________

Proposed Route (attach map): _________________________________________________________

____________________________________________________________________________________

Starting Location (identify on map): ____________________________________________________

____________________________________________________________________________________

Ending Location (identify on map): _____________________________________________________

____________________________________________________________________________________

Assembly Area (identify on map): ______________________________________________________

____________________________________________________________________________________

Disbanding Area (identify on map) : ____________________________________________________

____________________________________________________________________________________

Location(s) of Water Stations: _________________________________________________________

____________________________________________________________________________________

How many volunteers will staff the event: ________________________________________________

Special Guests (i.e., Governor, etc.): ____________________________________________________

____________________________________________________________________________________

Have Emergency Medical Service provisions been made?  Yes  No

PUBLIC WORKS

1) How do you plan to remove trash and garbage from the event site? ___________________________

____________________________________________________________________________________
Name of Private Contractor: ___________________________________ Phone: _________________
2) Will you be using generators or compressors?  Yes  No
Location and Type: __________________________________________________________________

____________________________________________________________________________________

3) How many portable toilets will you be providing for this event? _____________________________
Name of toilet company: ______________________________________ Phone: _________________

(Note: One toilet for every 500 people is requested for events lasting over 2 hours - an appropriate number of these toilets should be handicapped accessible.)
4) Will City water be needed?  Yes  No
If yes, describe in detail: _______________________________________________________________

____________________________________________________________________________________

5) Will you require the construction of any temporary structures or fixtures?  Yes  No
If yes, describe in detail: _______________________________________________________________

____________________________________________________________________________________

6) Will you require or intend on putting up a fence or other enclosure?  Yes  No
If yes, explain: _______________________________________________________________________

____________________________________________________________________________________

(NOTE: Enclosures require prior approval to ensure safety and proper crowd ingress/egress.)
7) Will you be erecting a tent?  Yes  No
If yes, describe in detail, including size: __________________________________________________

____________________________________________________________________________________

********** ATTENTION FESTIVAL AND/OR EVENT APPLICANT **********

The City of Wildwood will not allow any markings and/or painting of the streets, sidewalks, boardwalks or parking lots without approved marking devices. Devices will need to be visually approved by the Assistant Superintendent of Public Works prior to the event. If unapproved marking devices are used and applied, the event will be charged with the cost of removing and restoring to prior event status and future events will be in jeopardy of approval from this department.

Respectfully,

Mark D’Amico

Assistant Public Works Superintendent

ADVERTISING
1) Does the publicity plan for this event include?
 Internet  Email Radio/TV Print  Posters  Direct Mail
List Planned Internet Advertising: ______________________________________________________
List Planned Email Advertising: ________________________________________________________
List Planned Radio/TV Advertising: ____________________________________________________
List Planned Print Advertising: _________________________________________________________
List Planned Direct Mail Advertising: ___________________________________________________
2) Include copies of any direct mail/invitations/posters being sent.
3) Include copy of press releases/media kit.
4) Is there any business or residence that will be affected by this event?  Yes  No
If yes, what is affected? _______________________________________________________________

____________________________________________________________________________________

5) How can we remedy the situation? ______________________________________________________

____________________________________________________________________________________

BEACH PATROL

1) Is the event water or land based? _______________________________________________________

2) What portion(s) of the beach will be used and for what purpose? ____________________________

____________________________________________________________________________________

____________________________________________________________________________________
3) Do you anticipate the need for WBP staff to support your event?  Yes  No
If yes, approximately how many? ______________________________________________________
For what purpose? ___________________________________________________________________
4) Will you require the use of WBP facilities or vehicles?  Yes  No
If yes, please describe in detail, including dates and times: __________________________________

____________________________________________________________________________________

******
POLICE DEPARTMENT

1) Describe how you plan to provide security for the event: ____________________________________

____________________________________________________________________________________

a. Request for Police Security Detail (Certain police details may require reimbursement for services provided, e.g., overnight site security):

______________________________________________________________________________

2) Will a private security agency be used for this event?  Yes  No
a. If yes, what agency are they employed by? _________________________________________

______________________________________________________________________________
b. Number of security agents to be hired for the event __________________________________

Note: The City of Wildwood may require, in certain events, that Police Officers are

necessary to maintain order and control. This may require certain reimbursement to the

City of Wildwood for these services.
FIRE & EMS DEPARTMENT

1) Do you anticipate the need for Fire/EMS staff to support your event?  Yes  No

If yes, approximately how many personnel? ______________________________________________
2) Do you anticipate the need for engines/ambulances/EMS bike units?  Yes  No
If yes, how many _________________________________________________________
For what purpose? ___________________________________________________________________

____________________________________________________________________________________

3) Will you require the use of Fire Department facilities or portable equipment?  Yes  No
If yes, please describe in detail, including dates and times: __________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Note: The City of Wildwood may require, in certain events, that EMS or Fire

Protection services are warranted. This may require certain reimbursement to the

City of Wildwood for these services.
******

FIRE & HOUSING BUREAU

1) Will there be a bonfire, open flame, lighting, extinguishing or burning of any material?

 Yes  No
If yes, please describe in detail: ________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________
2) Application for a permit required by this code shall be made to the Fire Official in such form and detail as the Fire Official shall prescribe. Applications for permits shall be accompanied by plans or drawings as required by the Fire Official for evaluation of the application.
3) Type 1 Permit - $42.00
a. Bonfires;
b. The use of any open flame or flame-producing device, in connection with any public gathering, for purposes of entertainment, amusement or recreation.
4) If permit fees are collected the day of the event, that fee will be doubled. For example, a Type 1 permit would be $84.00 instead of $42.00.
_______________________________________ ________________________________________

Signature of Applicant Date

Event Chairperson Checklist

1) Is every section that is pertinent to my event completed?

 Yes  No
2) Is there a copy of insurance to be handed in?

 Yes  No

3) Is the City of Wildwood named as the additionally insured?

 Yes  No

4) Is the hold harmless completed?

 Yes  No

5) Is there a site plan defining the event?

 Yes  No

6) Is a copy of the extra materials included such as program schedule, vendor lists, maps, etc.?

 Yes  No

7) Do I have the Cape May County application for food vendor inspections?

 Yes  No

8) For billing purposes, please submit a copy of a current photo I.D. if you are requesting or required to utilize City services.

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