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Home My WebLink AboutRock on Water (BPW Approved 8/9/23) Sae 41 oEPaRr (. 4' " ' SPECIAL EVENT APPLICATION •n`,P 1 J / Submittal of this application does not guarantee approval of the event. R50O This application must be completed in its entirety.Any applications not completed will be denied automatically. Before applying,please acknowledge that addendum will be utilized in instances where additional liability on behalf of the applicant may occur.Applications must include a detailed site plan which clearly shows all temporary structures including but not limited to tents, portable toilets,stages, bleachers,dumpsters, fencing, inflatables,etc.at the time of submission. If you are applying on behalf of a nonprofit, please provide proof of organization's nonprofit designation. EVENT INFORMATION Name of Event. ROCK ON WATER Type of Event: FREE FAMILY EVENT - CHRISTIAN CONCERT Event Date(s): 9-9-23 Event Time: 4PM Event Day 2: Event Time: Event Day 3: ___ Event Time Event Location. JEFFERSONVILLE RIVERSTAGE Alternate Date, Time and Location. Will additional time be needed for set up/break down? rpeease cneck) I YES NO Set up will begin on (date) 9-9-23 at(time). 8:00AM Break down will begin on(date): 9-9-23 at(time): 1 U_00PM Please provide a detailed description of your proposed event(be specific; ROCK ON WATER IS A FAMILY FRIENDLY CHRISTIAN MUSIC FESTVIAL. HELD EACH YEAR IN SEPTEMBER. WE WILL HAVE SEVERAL ARTIST MAKING UP THE BILL. TO BE ANNOUNCED LATER IN THE SPRING OF 2023. Is this event open to the public?fpteasecheck) ■ YES I NO Estimated attendance: 4,000 Estimated number of teams participating?(athletic tournament only) 'Fees may be assessed during post went inspection it actual attendance exceeds above estimate. 1 ORGANIZATION INFORMATION Organization producing the event: (please check) ❑For Profit 0 Nonprofit ❑Governmental ❑Neighborhood Association 0 Other. NOT FOR PROFIT Name: JOYOUS NOISE MINSITRY Street Address: 1771 SUMMERLIN PLACE City:JEFFERSONVILLE State: IN Zip Code: 47130 websitPWwVV•JOYOUSNOISEMINISTRY.COM phone: 5028021648 Email: SCOttrrTT@SCOTTSHIREMAN.COM Social Mp1-ftpS://www.facebook.com/rockonwater SCOTT SHIREMAN On-site Contact Name___._ _ --__-_-- -- -_ __-- _.. On-site Contact Phone: 5028021648 On-site Contact EmaiISCOTT@SCOTTSHIREMAN.COM Phone number and/or email you want the public to contact for more information and to be listed online: 5028021648 Number of years this event has taken place in Jeffersonville: 10 Is this event produced in other areas?(please check) 0 YES • NO If so,where? COST b FUNDING Ticket Prices(If applicable): N/A Adults Children Seniors How will ticket sale revenue be used? If the proceeds of the event are intended for an organization other than the applicant,please provide the following information: Benefit Organization: of funds which will be donated:.___- -- -- _-.__._.-------___-_ ___..-----.---_.-- Contact Person:-- — --- -- --- - --- —-- — Contact Phone: Terms of the agreement: 2 ROAD CLOSURE Will your event require road closures?(please check) ]YES G NO If yes,please describe the roads that would be closed and provide the opening/closing dates and times.Also,please attach map detailing closures and cross streets. Name of streets: CORNER OF SPRING AND RIVERSIDE Date/Time of Closure:9-9-23 8AM Date/Time of Opening: PARKING Will you need any parking lots reserved for non-public use?(please check ❑YES !D NO Will you be using areas for off-site parking?(please check) 0 YES ❑NO TRAFFIC CONTROL Will your event require traffic control?(please check ❑YES 0 NO ALCOHOL Will alcohol be served at your event?(please check) C YES U NO FOOD /ram Will food be served at your event?(please check) Q YES NO If yes,will food be self-prepared?(please check) 0 YES NO INFLATABLE ATTRACTIONS: (P(asse make sure to include on site map) Will inflatable attractions(bounce houses,slides,games)be part of this event?(please check) Ei YES Li NO If yes,who will staff the attractions? G Vendor O Event Staff AMPLIFIED SOUND: Will amplified sound be used at your event?(please check) Id YES 0 NO If yes,what will be amplified(music,speeches,etc.)?(please check) OYES ❑NO If yes,what time(s)will sound be amplified? NOON - 10PM If yes,what sound company will provide sound? SUP AUDIO/VISUAL EQUIPMENT: Please list any AN equipment to be used at your event: WE WILL BE USING THE EQUIPMENT AT THE RIVERSTAGE 3 FENCING (Please make sure to include on site map) Will you be using temporary fencing for your event?(please check) O YES I NO /4q If yes,what company will provide fencing? REFUSE AND RECYCLING (Please make sure to Include on site map) Will you need refuse containers(dumpsters)for your event?(please check) iT YES ❑NO If yes,how many will be used? 2 DUMPSTERS if yes,what company will provide refuse and recycling services? RESTROOMS (Please make sure to include on site map) Will your event require temporary restrooms?(please check) AYES ❑NO If yes,how many? If yes,what company will provide restroom services? MORE TO COME CLEAN-UP: Will you use a cleaning company for event clean-up?(please check ❑YES M NO If yes,what company will provide cleaning service? ELECTRICITY: Will you be using temporary electric(generator)at your event?(please check C YES E NO n If yes,what company will provide electric service? TENTS (Please make sure to include on site map) Will you be using tents,stages,ticket booths,etc.at the event?(please check YES ❑NO If yes,will tents be larger than 150 square feet(larger tents require permit)?(please check)❑YES C NO If yes,please Indicate the number and size of tents and desribe how tents will be used: If yes for larger tents,what company will be providing tents? PROMOTING/ADVERTISING: What type of promotion/advertising do you have planned for your event? RADIO, TV AND PRINT 4 SIGN AND RETURN this completed application with supporting documents to the Jeffersonville Parks .... Department, Attn. City Events Planning Board. Email par ksrnto@cityofieff.net Mail 500 Quartermaster Court Jeffersonville, IN 47130 Applicant agrees that the contents of the application are complete, true and accurate to the best of their knowledge. information and belief. ana agrees to ensure compliance with the policies set by the City Events Planning Board 5 .�� ik U. 1 /30/23 Signature of Applicant Date *Upon approval by the City Events Planning Board, applicant will be required to pay the Special Event Permit Fee determined by the Board. This fee is usually set at 5150 per application, but may be increased depending on use of city services. risk assessment or other factors. **A certificate of insurance is required for all events, with minimum coverage of S1.000.000 liability. The certificate must list the City of Jeffersonville as addition I insured. and must be submitted to the Parks Department at least 10 days prior to the event date ,ii"s/h\��•\��. \/ ..'qP This section to be completed by City Events Planning Board PERMIT FEE CI 11-$ I G co Receipt# ' 12� �J APPROVED BY /ate - U'�.5 Police:, i Fire- •,-.•• 1-------1' Str /� Parks. 0,43.0 Safety- Director. )\-_;/-----v::_______ 5 g _- (of.i.'s, .. ___—\ ___i 0 ._ Q C ,r ..., __,,. 0 (,-.4.) (e• * - _ j , ��l yin 0 ____*4_, .., - , 1.1 43• __ opt - 79q ' _ \ 7).' :_r, 4-'---:-)° -)...,,i-y., I -)1.-e- _, \ #4 102cri. ✓�1,,, v v f' r' / ?, `i`.rvd -I 5-1-L 1 , 71 rI- 5 c,r —"— u:,z ( cjsue be_ LC{}Q-, . t:d-e d_Y'e- ? Od k c ec� - ,s�� n n -I c, rfdts (-c- e. Q -, ' -4 4--7Y--7 --toy .._7---j, yct- --?p.1,,c --Y- P.- -' ... c; , ' , M (3. a7 1 1 ? a "7"' „Pry a�+�i • _____________._________._____-•' c...-1) 3fA____,..._7_2,2_.j 5J-6), a ,Q 11 P - • ( 1 Ezaz 1 a %14