Special Event Application

Applicant

The sponsor and coordinator who will be the main contact for this application.

Full name

Email

Phone

Property address at the community

I am the

Mailing address (if different)

Event Details

Name of event

Location of event in the community For example, the park, a street, or your property address.

Start date

Start time

End date

End time

Description of the event

Number of participants / expected attendance

Amplified sound?

Yes No

Animals?

Yes No

Alcohol sales or service?

Yes No

Vendors or sponsors?

Yes No

Temporary gate code needed?

Yes No

Event Operator

Complete only if the company, group, or person producing the event is different from the applicant.

Operator name

Business license number

Operator phone

Operator email

Event site phone

Event Plan

Will a City of Henderson event permit be required?

Yes No Not sure

Will a Fire Department permit be required?

Yes No Not sure

Who is responsible for clean up? Briefly outline the plan.

Who is responsible for crowd control? Briefly outline the plan.

Parking areas, including disabled access and barricades

Location of restrooms, concession stands, rides, recycling and trash containers, and exits

Traffic control plan for any impact to public rights of wayWrite "None" if the event will not affect public streets.

Tent locations and dimensionsWrite "None" if there will be no tents.

Attachments

Site plan showing the location and basic layout of the event

Certificate of liability insurance (Association and Assured Real Estate listed as additional insureds)

City or Fire Department permits (if required)

Additional file (optional)If your files are larger than 8 MB in total, submit the application without them and email them to management with your property address in the subject line.

Acknowledgment and Signature

I understand that we are responsible for the actions of all invitees and guests, and I will indemnify and hold the Association and Assured Real Estate harmless for any claims associated with the event.

Signature

Date

I agree that typing my name above is my electronic signature and has the same effect as a handwritten signature.