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2. Special Event Permit Application
4. Event Name*
6. Sponsoring Organization*
8. Organization Address*
10. City*
11. State*
12. Zip Code*
14. Responsible Representative*
15. Contact Phone Number*
17. Contact Email Address*
21. Event Details
23. Event Location*
24. You must upload an Event Site Plan*
26. Event Date*
    Event Date
27. Event Times*
    Event Times Start Time

    —

    Event Times End Time
29. Type of Event Activity*
    -- Select One --FestivalWalk/RunVendor MarketFundraiserHoliday CelebrationFireworksSporting TournamentCar ShowCarnival
30. Event Description*

    (Purpose)

32. Please describe in detail your event and the activities that will take place*
34. Event/Organization Web Address*
36. How will the Event be Publicized?*

    Social Media, posters/flyers, press releases, newspaper ads, website, etc.

37. Event Promotional Material
39. Is this an Annual Event?*

    1. Yes

    1. No
40. If yes, number of years?
41. If yes, what was last year's total attendance?

    Total attendance includes event crew, participants and spectators

    
    

43. Anticipated Total Attendance?*

    Total attendance includes event crew, participants and spectators

44. Number of Event Participants*

    Staff/Volunteers, Performers, Vendors, etc.

45. Method of Notification of Participants*

    Paper application, online registration, etc.

46. Is there a participant registration fee?*

    1. Yes
    2. No
48. Please list any entertainers & music/entertainment details*

    For Example: Local musicians only; Puppet Show on a 10x15ft portable stage; Live band with amps, speakers, and microphones; Multiple bands with opening acts and a headliner; colored lighting and smoke machine; etc.

49. Entertainment Schedule

    Soundcheck, performance timeline, etc.

51. Setup Start Date & Time*
    Setup Start Date & Time

    Setup Start Date & Time
52. Cleanup/Breakdown Completion Date & Time*
    Cleanup/Breakdown Completion Date & Time

    Cleanup/Breakdown Completion Date & Time
56. City Services
58. (please note that City will determine final requirements regarding requests)
60. Street Closure Request?*

    1. Yes

    1. No
61. If Yes, list street name(s)
63. Closure of Parking Lot for use Request?*

    1. Yes

    1. No
64. If Yes, select parking lot(s)
    -- Select One --Entire Lot Adjacent to Tybrisa Street RoundaboutHalf Lot Adjacent to Tybrisa Street Roundabout up to 17th StNorth Beach Gravel LotNorth Beach Nook in Gravel LotNorth Beach Tom Lynch Loop Lot
66. I understand that at least one officer is required for a special event at the rate of $55 per hour with a four hour minimum*

    1. I agree
68. Will you request more than one on site Police personnel during the event?*

    (note that City will determine final number of personnel required)

    1. Yes

    1. No
70. If Yes, how many total officers?

    (note that City will determine number of personnel required)

71. Shift Date/Times
    Shift Date/Times Start Date

    Shift Date/Times Start Time

    —

    Shift Date/Times End Date

    Shift Date/Times End Time
73. Are there any requests for on site Fire, EMT or Ocean Rescue personnel during the event?*

    (note that City will determine final number of personnel required)

    1. Yes

    1. No
75. Event Infrastructure Requests:*

    (note that City will determine the quantity required)

    1. Barricades
    2. Cones

    1. No Parking Signs
    2. Portable Lights

    1. Electronic Message Board
    2. Extra Trash Receptacles

    1. No Public Infrastructure Requests
77. Does your event have electrical needs?*

    1. Yes

    1. No
78. Will your event have amusement rides?*

    1. Yes

    1. No
80. Will alcoholic beverages be served during the event?*

    (If Yes, liquor liability insurance must be included on the COI)

    1. Yes

    1. No
81. Will there be any tents, stages, or other structures larger than 10ft x 10ft?*

    1. Yes

    1. No
83. Will your event have vendors?*

    1. Yes

    1. No
84. If Yes, approximately how many vendors?
86. Will your event have food trucks?*

    Requires inspection to be scheduled with Fire Department prior to event start 

    1. Yes

    1. No
87. If Yes, approximately how many food trucks?
89. Are you requesting the City to activate the control zone for this event?*

    1. Yes

    1. No
91. Additional City Permits

    1. Banner*

    1. Vendor

    1. Tent/Canopy

    1. Beach*
93. *You must make an event banner permit location reservation online.
    To make an event banner permit reservation CLICK HERE.
94. *You must make a beach event permit area reservation online.
    To make a beach event permit area reservation CLICK HERE.
96. Other Permits

    1. DNR

    1. GDOT

    1. County
100. Permit Requirements
102. I understand the permit application fee must be paid*

     1. I agree

     CLICK HERE to pay the permit application fee

104. You must upload the COI

     The COI (Certificate of Insurance) must provide a policy limit of no less than $1,000,000.00 with the City of Tybee Island listed as additional insured and certificate holder 

     *If you do not have a COI at the time of application submission, proof that you are able to obtain a COI may be provided

106. Do you have additional Event Liability Insurance other than the COI required with the City?*

     1. Yes

     1. No
107. Upload any additional proof of insurance here
109. Include the name and address of all natural persons or organizations controlling at least five percent stake in the event
111. Name*
112. Address*
114. City*
115. State*
116. Zip Code*
118. Indemnification Agreement and Acceptance to Adhere to Application Requirements*

     I, individually and as the Agent representing the Event Organization, do hereby agree to indemnify and hold harmless the City of Tybee island, Georgia, its officers, agents, employees and contractors from and against any and all loss, damage, claim, demand, liability or expense by reason of any damage or injury to property or person which may be claimed to have arisen as a result of or in connection with the occupancy or use of listed event premises during the time period of said event. 

     Such obligation to indemnify and hold harmless shall continue notwithstanding any negligence or comparative negligence on the part of the City relating to such loss or damage, except for loss or damage arising from the sole negligence or willful misconduct or gross negligence of the city, and shall include all costs, expenses and liabilities incurred by the City in connection with any such claim, suit, action or cause of action, including the investigation thereof and the defense of any action or proceeding brought thereon and any other judgment or decree which may be entered in any such action or proceeding or as a result thereof. These provisions shall survive the expiration or earlier termination of the use of premises. Nothing in this Agreement shall be construed to affect in any way the City’s rights, privileges, and immunities as set forth in Georgia Statutes and/or the Constitution of the State of Georgia.

     1. I agree
120. Today's Date*
     Today's Date
122. Is today's date within 6 months of your event date?*

     1. Yes

     1. No

     *special event applications may be submitted no sooner than six months before the opening of the event to the public

123. Is today's date at least 60 days prior to your event date?*

     1. Yes

     1. No

     *special event applications may be submitted no less than 60 days before the opening of the event to the public.

Leave This Blank:


125. 1. Receive an email copy of this form.
126. Email address

     This field is not part of the form submission.

127. Submit

* indicates a required field