HomeMy WebLinkAboutTUPType of Event:
_ Public Concert _ Fair _ Festival
_ Parade X Demonstration _ Circus
_ Motion Picture _ Grand Opening _ Other
Event Title: 6.162-1' 4-1 �'R`-t`,..) AAA
_ Community vent
_ Block Party
Event Location: "Sv= �-x"-'sue- -ch'4 Sc �L-
Event Date(s): From IS't 3 to J5%bt3
Actual Event Hours: 0e00 Cam to t400
am/Cm
Total Anticipated Attendance: aim (4D Participants 2512) Spectators)
Setup/assembly/construction Date:CiS%S.' 3 Start time:
Please describe the scope of your setup/assembly work (specific details):
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Dismantle Date: OS S Completion Time: \4c070 am/ r�
List any street(s) requiring closure as a result of this event. Include street name(s), day
and time of closing and day and time of reopening.
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Sponsoring Organization: is PeTrsrn.-c-
Chief Officer of Organization (Name) 404-• v -,hu.& _- Osoct-.. b,,.-z
Applicant (Name): kia,..01
Address: t'Zc» t-rt-4, �cr. cpt
Daytime Phone: ((,tG() 35(4 • 4444 Evening Phone: (tack) Sac S1gv
Fax: ( SILe -44s4 E-Mail: gyc, jC qk,. c..k,1 a .
Contact Person "on site" day of the event: Cx,
Cellular: «) SS`t • SIRte
NOTE: THIS PERSON MUST BE IN ATTENDANCE FOR THE DURATION OF THE EVENT
AND IMMEDIATELY AVAILABLE TO CITY OFFICIALS
Is your organization a "Tax Exempt, nonprofit" organization? ✓YES _ NO
Are admission, entry, vendor or participant fees required? _ YES ✓60
If YES, please explain the purpose and provide amount(s):
$ Estimated Gross Receipts including ticket, product and sponsorship
sales from this event.
$ (co,coo
Estimated Expenses for this event.
$ -JO" What is the projected amount of revenue that the Nonprofit
Organization will receive as a result of this event?
Please provide a DETAILED DESCRIPTION of your event. Include details
regarding any components of your event such as the use of vehicles, animals,
rides or any other pertinent information about the event.
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YES ✓NO If the event involves the sale of cars, will the cars come exclusively from National
City car dealers?
If NO, list any additional dealers involved in the sale:
YES ✓NO Does the event involve the sale or use of alcoholic beverages?
YES ✓NO Will items or services be sold at the event? If yes, please describe:
YES ✓FIO Does the event involve a moving route of any kind along streets, sidewalks or
highways? If YES, attach a detailed map of your proposed route indicate the
direction of travel, and provide a written narrative to explain your route.
YES _ NO Does the event involve a fixed venue site? If YES, attach a detailed site map
showing all streets impacted by the event.
_ YESO Does the event involve the use of tents or canopies? If YES: Number of
tent/canopies Sizes NOTE: A
separate Fire Department permit is required for tents or canopies.
_ YES ✓t O Will the event involve the use of the Cy or your stage or PA system?
SPECIFY:
In addition to the route map required above, please attach a diagram showing the overall layout
and set-up locations for the following items:
Alcoholic and Nonalcoholic Concession and/or Beer Garden areas.
Food Concession and/or Food Preparation areas Please describe how food will be served
at the event:
If you intend to cook food in the event area please specify the method:
GAS ELECTRIC CHARCOAL OTHER (Specify):
Portable and/or Permanent Toilet Facilities
Number of portable toilets: (1 for every 250 people is required, unless the applicant can
show that there are facilities in the immediate area available to the public during the event)
Tables # and Chairs #
✓'Fencing, barriers and/or barricades — gi n, . „z- -- `p" N* -to
Generator locations and/or source of electricity
Canopies or tent locations (include tent/canopy dimensions)
Booths, exhibits, displays or enclosures
Scaffolding, bleachers, platforms, stages, grandstands or related structures
Vehicles and/or trailers — vwer vc-. --r+,e-. c
Other related event components not covered above
Trash containers and dumpsters
(Note: You must properly dispose of waste and garbage throughout the term of your
event and immediately upon conclusion of the event the area must be returned to a clean
condition.) Number of trash cans: Trash containers with lids:
Describe your plan for clean-up and removal of waste and garbage during and after the event:
Please describe your procedures for both Crowd Control and Internal Security:
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_ YES O Have you hired any Professional Security organization to handle security
arrangements for this event? If YES, please list:
Security Organization:
Security Organization Address:
Security Director (Name): Phone:
_ YES ✓`VO Is this a night event? If YES, please state how the event and surrounding area will
be illuminated to ensure safety of the participants and spectators:
Please indicate what arrangement you have made for providing First Aid Staffing and Equipment.
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Please describe your Accessibility Plan for access at your event by individuals with disabilities:
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Please provide a detailed description of your PARKING plan:
wiIN, •
Please describe your plan for DISABLED PARKING:
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Please describe your plans to notify all residents, businesses and churches impacted by the
event: 14 c-PC hre ck 'ly b‘ c)-6" rs t.4 't ` '
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NOTE: Neighborhood residents must be notified 72 hours in advance when events are
scheduled in the City parks.
— YES ✓NO Are there any musical entertainment features related to your event? If YES,
please state the number of stages, number of bands and type of music. Number
of Stages: Number of Bands:
Type of Music:
✓YES _ NO Will sound amplification be used? If YES, please indicate: Start time:
klab. m m Finish Time V'Z_(
am'e:)
V YES _ NO Will sound checks be conducted prior to the event? If YES, please indicate: Start
time: tO5D arJ7 pm Finish Time k Ste' Opm
Please describe the sound equipment that will be used for your event:
_ YES ✓NO Fireworks, rockets, or other pyrotechnics? If YES, please describe:
YES . NO Any signs, banners, decorations, special lighting? If YES, please describe:
Revised 02/29/12
City of National City
PUBLIC PROPERTY USE HOLD HARMLESS AND
INDEMNIFICATION AGREEMENT
Persons requesting use of City property, facilities or personnel are required to
provide a minimum of $1,000,000 combined single limit insurance for bodily
injury and property damage which includes the City, its officials, agents and
employees named as additional insured and to sign the Hold Harmless
Agreement. Certificate of insurance must be attached to this permit.
Organization c-PD
Person in Charge of Activity
Address V24-
Telephone L0 Fite' x4c42 Date(s) of Use OS- %s — oa ‘co rs
HOLD HARMLESS AGREEMENT
As a condition of the issuance of a temporary use permit to conduct its activities
on public or private property, the undersigned hereby agree(s) to defend,
indemnify and hold harmless the City of National City and the Parking Authority
and its officers, employees and agents from and against any and all claims,
demands, costs, losses, liability or, for any personal injury, death or property
damage, or both, or any litigation and other liability, including attorneys fees and
the costs of litigation, arising out of or related to the use of public property or the
activity taken under the permit by the permittee or its agents, employees or
contractors.
Signature of Applicant Official Title Date
Sc..s'
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For Office Use Only
Certificate of Insurance Approved Date
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Life's lessons are best learned through experience. Unfortunately, when the target audience is
teens and the topic is drinking and texting while driving, experience is not the teacher of choice.
The Every 15 Minutes Program offers real -life experience without the real -life risks. This
emotionally charged program, entitled Every 15 Minutes, is an event designed to dramatically
instill teenagers with the potentially dangerous consequences of drinking alcohol and texting
while driving. This powerful program will challenge students to think about drinking, texting while
driving, personal safety, and the responsibility of making mature decisions when lives are
involved.
During the first day events the "Grim Reaper" calls students who have been selected from a
cross-section of the entire student body out of class. One student is removed from class every
15 minutes. A police officer will immediately enter the classroom to read an obituary which has
been written by the "dead" student's parent(s) - explaining the circumstances of their
classmate's demise and the contributions the student has made to the school and the
community. A few minutes later, the student will return to class as the "living dead," complete
with white face make-up, a coroner's tag, and a black Every 15 Minutes T-shirt. From that point
on "victims" will not speak or interact with other students for the remainder of the school day.
Simultaneously, uniformed officers will make mock death notifications to the parents of these
children at their home, place of employment or business.
After lunch, a simulated traffic collision will be viewable on the school grounds. Rescue workers
will treat injured student participants. These students will experience first hand, the sensations
of being involved in a tragic, alcohol -related and texting while driving collision. The coroner will
handle fatalities on the scene, while the injured students will be extricated by the jaws -of -life
manned by Fire -Fighters and Paramedics. Police Officers will investigate, arrest, and book the
student "drunk driver". Student participants will continue their experience by an actual trip to the
morgue, the hospital emergency room, and to the police department jail for the purpose of being
booked for "drunk driving".
At the end of the day, those students who participated in the staged accident as well as those
who were made-up as the "living dead" will be transported to a local hotel for an overnight
student retreat. The retreat will simulate the separation from friends and family. A support staff of
counselors and police officers will facilitate the retreat.
During the most powerful program of the retreat, the students will be taken through an audio -
visualization of their own death. Then each student will write a letter to his or her parents starting
out with .. .
"Dear Mom and Dad, every fifteen minutes someone in the United States dies
from an alcohol related traffic collision, and today I died. I never had the
chance to tell you
Parents will also be asked to write similar letters to their children. These letters will be shared
tha fnllnwinn day whan cti irfants and narants will ha raunitarf at a rt hnnI accamhly
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The students will engage in challenging and interactive exercises. Impaired simulator goggles
will be used to allow students to experience firsthand the potentially fatal consequences of
alcohol and drug impairment. The goggles will allow students the opportunity to understand the
dangers of impaired driving without taking a drop of alcohol or using drugs of any type. Research
shows that those who learn from hands-on experience retain two to four times more than those
who learn from just listening, or from listening and seeing.
"Grim Reaper" and the staged crash. The assembly will be hosted by an Officer (Project
Coordinator), who will guide the audience through the devastating effects of losing a loved one
due to a bad choice. Speakers will include students who will read letters to their parents, police
officers, and hospital personnel who shared their emotional trauma of dealing with kids killed in
traffic crashes. Parents will share their personal reflections of their involvement in this program.
We will also have a powerful speaker who actually lost a child to a drunk driver, or as the result
of driving while under the influence or texting while driving.
The focus of the assembly stresses that the decision to consume alcohol can affect many more
people than just the one who drinks and the dangers of texting while driving. This very emotional
and heart -wrenching event will illustrate to students the potentially dangerous consequences of
their use of alcohol and texting while driving, regardless of how casual they believe their use is.
This event includes the participation of our Police and Fire Departments, High School Staff,
Local Hospital, Video Production Crew, Community Officials, District Attorney's Office, Funeral
Homes and a wide cross-section of the community at -large. It is our goal to utilize the strength,
talent and resources of business and industry to prevent drunk driving and texting while driving.