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2. 

   220 South Market Street Oskaloosa, Iowa 52577 P: 641.673.9431
4. Special Event Application
   The following application will provide the city's Special Events Committee the information needed to gain approval to host an event that will occur on public property, including but not limited to city parks, streets, and/or sidewalks. Once submitted, the committee will review your request and you will be notified of the outcome. You may anticipate a response within 2 -3 business days. Thank you for your interest in holding a event in our community!
6. Attestation*

   By completing this application, I acknowledge the following: 1. I am 21 years of age or older. 2. I have reviewed the online Special Event Guide or a paper version, and will adhere to the Special Event requirements and the Agreement below. 3. I understand fees may apply once an event is approved and are due and payable prior to the event.

   1. I attest to each of the above items.
8. Additional documents may be needed to complete this application and may be uploaded in box 9. Please review all the information below prior to beginning to be properly prepared for submission. All starred (*) items require an answer to complete this form.
10. Insurance certificates
    Some events, such as those where alcohol is served or large crowds are anticipated, will require the applicant secure general liability insurance, including liquor liability if applicable. Minimum coverage limits of $1,000,000 per occurrence and $2,000,000 annual aggregate will be required for these events. Applicant is required to provide a certificate of insurance documenting the coverage and listing the City of Oskaloosa as a Certificate Holder. You will be notified if your event requires an insurance certificate.
12. Event Title*
13. Organization or Individual Name*
15. Contact Person*
16. Contact Phone Number*
17. Contact Email Address*
19. Event location being requested*
    -- Select One --City SquareBandstand onlyCity StreetRecreation TrailOther
20. Please provide a description of the event*
24. Actual date and time event will occur
    NOTE: Add set-up and tear down in the next step*
    Actual date and time event will occur
    NOTE: Add set-up and tear down in the next step Start Date

    Actual date and time event will occur
    NOTE: Add set-up and tear down in the next step Start Time

    —

    Actual date and time event will occur
    NOTE: Add set-up and tear down in the next step End Date

    Actual date and time event will occur
    NOTE: Add set-up and tear down in the next step End Time
25. Set Up Date/Time*
    Set Up Date/Time

    Set Up Date/Time
26. Tear Down Date/Time*
    Tear Down Date/Time

    Tear Down Date/Time
30. 1. Is this a Chamber/Main Street sponsored event?*
    -- Select One --YesNo
31. 2. Estimated number in attendance; certificate of insurance required for larger events*
32. 3. Should the bandstand music be left on or turned off during your event?*
    -- Select One --Leave bandstand music onTurn bandstand music off
36. 4. Will sound amplification be used that will allow sound to be heard at a distance of one hundred feet or greater from its source (i.e., band, loudspeaker, CD, radio)?
    PLEASE NOTE: Event organizer responsible for securing own equipment; City does not supply microphones or speakers.
    -- Select One --Yes, I have the required Noise permit. List permit holder name in 4a.Yes, I will obtain the required Noise permit prior to the event. List permit applicant name in 4a and review the Noise Exemption Permit requirement information.No, there will be no sound amplification.Not applicable to this event
37. 4a. Noise Exemption Permit Holder/Applicant Name
38. Noise Exemption Permit requirement information
    Click here
42. 5. Will money be collected in the form of admission/registration fees or merchandise/food sales?*
    -- Select One --Yes; there will be admission/registration fees although no other money will be collected for merchandise/food.Yes; there will be merchandise/food sales and I have the required permits. List permit holder name in 5a.Yes; there will be merchandise/food sales and I will obtain the needed permit(s) prior to the event. List permit applicant name in 5a and review the Peddlers, Solicitors, and Transient Merchant info.No; there will be no merchandise/food sales at the event.
43. 5a. Peddler, Solicitor, and Transient Merchant Permit Holder/Applicant Name
44. Peddlers, Solicitors, and Transient Merchant requirement information
    Click here
48. 6. Will alcohol be sold at the event? If yes, see info to right.*
    -- Select One --Yes; I have a liquor license for the event. Provide license holder name in 6a.Yes; I will obtain the needed license prior to the event. Provide license applicant name in 6a and review the link for liquor license.No; there will no alcohol sold at the event.
49. 6a. Liquor License Holder/Applicant Name
50. Alcohol vendors are required to have a current liquor license from the State of Iowa; click link for information. Questions? Call the city clerk's office at 641.673.9431, option 4 for assistance.
    Click here
54. 7. Does the event require city streets to be closed/barricaded?*
    -- Select One --Yes; Street closures have a $25 fee. Please list the streets to be closed in box 7a.No; no street closures/barricades are needed.
55. 7a. Streets to be closed; attach a map in box 9 showing the closures.
59. 8. Will equipment, signs, decorations, lighting, tents, or other structures or objects be installed?*
    -- Select One --Yes; Code restrictions may apply. Please provided a detailed description in box 8a.No
60. 8a. Detailed description about equipment, signs, etc:
64. 9. Please upload supporting documents here, i.e., maps for road closures or runs/walks, certificates of insurance, etc. If you are unable to upload your documents, email to city@oskaloosaiowa.org.
66. 10. Provide any additional information about the event in the box below. Please Note: The applicant/host is responsible for cleaning the event area, disposing of waste/trash, and returning the area to a condition similar to prior to use.
68. AGREEMENT
    
    In consideration of the city of Oskaloosa, Iowa, granting permission for the activity described above, the undersigned indemnifies and holds harmless the city of Oskaloosa, Iowa, its employees, representatives and agents against all claims, liabilities, losses or damage for personal injury and/or property damage or any other damage whatsoever on account of the activity described above and/or deviation from normal City regulations in the area. The undersigned further agrees to indemnify and hold harmless the city of Oskaloosa, Iowa, its employees, representatives and agents against any loss, injury, death or damage to person or property and against all claims, demands, fines, suits, actions, proceedings, orders, decrees and judgments of any kind or nature and from and against any and all costs and expenses including reasonable attorney fees which at anytime may be suffered or sustained by the undersigned or by any person who may, at anytime, be using or occupying or visiting the premises of the undersigned or the above-referenced public property or be in, on or about the same, when such loss, injury, death or damage shall be caused by or in anyway result from or rising out of any act, omission or negligence of any of the undersigned or any occupant, visitor, or user of any portion of the premises or shall result from or be caused by any other matters or things whether the same kind as, or of a different kind that the matter or things above set forth.The organization/applicant hereby waives all claims against the City for damages to the building or improvements that are now adjacent to said public property or hereafter built or placed on the premises adjacent to said property or in, on or about the premises and for injuries to persons or property in or about the premises, from any cause arising at any time during the activity described above. The undersigned further agrees to comply with all the rules, regulations, terms and conditions established by the city of Oskaloosa, Iowa.
70. By submitting this application, the applicant acknowledges that they have read and fully understand this application, including the fact it is releasing and waiving certain potential rights, and that they voluntarily and freely agree to the terms and conditions as set forth herein.
72. Submitter First and Last Name*
73. Submission Agreement*

    By checking this box, I agree that the information in this application is accurate to the best of my knowledge.

    1. Yes
75. Review and Notification
    The Special Events Committee will review your application and their response will be provided to you, normally within 2-3 business days.
Leave This Blank:


77. 1. Receive an email copy of this form.
78. Email address

    This field is not part of the form submission.

79. Submit Submit and Print

* indicates a required field