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2. Event Name:*
3. Event Location & Date/Time*
5. Event Sponsor:*
6. Event Co-Sponsor:
8. If this is a fundraising event, who or what entity will benefit from the proceeds?
9. What fees or charges are required or associated with the event?
11. Approximate Anticipated Spectator Attendance:*
12. Approximate Parking Requirements:*
14. Will there be any of the following (check all that apply)?*

    1. Animal Rides
    2. Cookers/Grills
    3. Musicians
    4. Moonwalk/Bounce House

    1. PA System
    2. Petting Zoo
    3. Performers
    4. Portable Stage

    1. Tables/Chairs
    2. Other
    3. None of the above
15. List Other here:
17. If you will be having a bounce house or staging, you must provide a Certificate of Insurability meeting the County's standards/approval.
    Please upload copy of Certificate of Insurability (COI) above.
21. Vendor Information - Please fill out below if applicable
    If private vendors will be selling food, products, or some other services during this event, please fill out below.
23. Approximate Vendor Attendance:
24. Vendor Space/Size Requirements:
26. Please check all Vendor types that apply:

    1. Food/Concession Carts
    2. Crafts
    3. Media
    4. Games

    1. Beverage Carts/Stands
    2. Tent Setup Required
    3. Other:
27. List Other here:
29. *Alcohol is NOT allowed on County Property*
31. I/We understand that it is my/our responsibility to advise ALL VENDORS of their obligation to have the appropriate operational license/s (if applicable) and to collect and pay all applicable state sales tax as required by the State of Florida. Failure to relay this information could result in fines to me/us and/or the participating vendor/s.
35. Please provide a separate drawing and/or written description of how the event elements will be laid out during this event.
36. Tent Placement and Setup MUST be identified on drawing.
37. Please combine your pages into one document and upload them below.
39. Please provide a separate drawing and/or written description of how the event elements will be laid out during this event.
40. Tent Placement and Setup MUST be identified on drawing.
41. Please combine your pages into one document and Upload layout drawing of event setup and tent placement below.
43. Will the following be needed?

    1. Water
    2. Electricity
44. What is the purpose of water needed?
45. How many outlets are needed?
47. Are you requesting permission for a road to be closed during this event?
    -- Select One --YesNo
48. Have you submitted this request in writing to the appropriate City, Sumter County Public Works or FDOT?
50. Does applicant/agency carry liability insurance to cover events such as this?

    1. Yes
    2. No
51. Please list limits below along with contact information for Insurance Carrier:
53. Please list below any security plans, who is responsible for coordinating with security and their contact information, and what security will be used for:
55. Who is in charge of coordinating cleanup after the event and please provide their contact information:*
57. I/We, fully understand that completion/submittal of this application does not confirm my/our request and that ALL requests are subject to review by County Facilities & Park Staff, Risk Management, Law Enforcement and other applicable Departments or Agencies prior to approval. All requests are processed on a first come first serve basis. Upon review, a designated staff member will notify me or one of my contacts regarding the status of this request and whether or not any additional information, deposits or others fees are required. I/We also acknowledge that I/We have received a copy, read, understand and fully agree to all of the items and terms outlined in the Facility Usage Agreement, including how to proceed in the event of any emergencies needing immediate attention during this event. I/We further affirm that the information contained in this application is true and correct to the best of my knowledge.*

    1. I agree with the statement above.
Leave This Blank:


59. 1. Receive an email copy of this form.
60. Email address

    This field is not part of the form submission.

61. Submit

* indicates a required field