HomeMy WebLinkAbout11-234MAY 24, 2011 11 -234 RESOLUTION
(CARRIED 6 -0 LOST LAID OVER WITHDRAWN )
PURPOSE: APPROVAL OF SPECIAL EVENT /OSHKOSH SENIORCENTER/
UTILIZE SOUTH PARK SHELTER & SURROUNDING GROUNDS
FOR THEIR OSHKOSH SUMMER GAMES / JUNE 20 & 22, 2011
INITIATED BY: CITY ADMINISTRATION
NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of
Oshkosh that approval is granted to Oshkosh Senior Center (Molly Butz) to utilize South
Park Shelter and Surrounding Grounds on Monday, June 20, 2011, from 8:30 a.m. to 3:00
p.m. and Wednesday, June 22, 2011 from 8:30 a.m. to 12:00 pm for their Oshkosh
Summer Games in accordance with the municipal code and the attached application, with
the following exceptions /conditions:
BE IT FURTHER RESOLVED that as a condition of approval, the Event Organizer
shall pay the City's actual costs for extraordinary services.
Cost Estimates for Extraordinary Services
none
APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RET E�, T 0- GJ�I'r' �J
CLERK `�
GENERAL EVENT INFORMATION
7pPR 21 201
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Official Name of, Special Event:
Start Date: Y1 End Date
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EVENT
SUN
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WED
THUR
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SAT
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SETUP TIME
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START TIME
STOP TIME
TEAR DOWN
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Location of Eve
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Estimated Attendance (daily & total): 90 Number of
Booths: 40 - t nzs I
Organization(s) Sponsoring Event:
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Briefly describe your event. Be sure to include the purpose of the event and all
I d f ies. 'f
APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY
CLERK
Primary Contact: O I 1 �Z
Daytime Telephone:
Cell Phone: 920 12-0 b 3 n
Fax: 20 Z
1r1�tA Z Ll n ch S�'I. UUI (
Email:
Address:
City: l
Secondary Contact:
Daytime Telephone:
Cell Phone:
Fax-
K be 11 1"�J
State: VV
Email:
Address:
City: _
Onsite Primary Contact:
Cell phone:
Fax-
Email:
Address:
City: _
Onsite Secondary Contact:
Cell phone:
Fax-
Zip Code
State:
State: Zip Code:
Email:
Address:
City: _
State:
Zip Code:
Zip Code:
NOTE Either the primary or secondary onsite contact must be present onsite at
all times during the event.
APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY
CLERK
SPECIAL EVENT CHECKLIST
(please check all boxes that apply)
Is your event a:
❑ Festival / Music Concert
• Religious / Educational
• Rally / Memorial
❑ Street / Block Party
❑ Parade / Fun Run / Walk- a -Thon
• March utilizing any Public Property
• Public Assembly for Political Purpose
• Sport Tourname t (Fishing, Soccer, etc.)
Other f - 4 k`` WQ
Location of event:
Park or other public property
• Public street, sidewalk, alley, or right of way
• Private property
Will you have
❑ Alcoholic beverages
(Additional permit required from City Clerk)
Food & non - alcoholic beverages
(Additional permit required from Health Dept.)
❑ Non -food related sales and /or display booths
(No additional permits required)
❑ Tent and /or Canopy
(Additional permit required from Inspections Dept.)
(Digger's Hotline must be contacted minimum of 3 days before digging)
❑ Generator(s) and /or additional electrical facilities
(Additional permit required from Inspections Dept.)
❑ Fires or Candles
(Additional permit required from Fire Dept.)
❑ Fireworks
(Additional permit required from Fire Dept.)
❑ Activities in a park outside of normal operating hours
(Waiver required from City Council)
❑ Barricades
(Approval from City Clerk's office if in right of way)
APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY
CLERK
❑ Amplified Sound
❑ Animals included or allowed in event
(animals must be licensed and have proof of vaccination)
Cooking Equipment
(Fire Department approval required)
We have made arrangements for
❑ Restroom and hand washing facilities
❑ Solid waste and recycling services
❑ Event insurance
❑ Public safety & security / EMS services
❑ Electricity / Generators
❑ Fire extinguishers
❑ Advertising with banners or signs
'X Drinking water
❑ Grey water and grease removal
❑ Weather contingencies
❑ LP Gas
❑ Tent Heating
Space Intentionally Left Blank
APPLICATION FOR SPECIAL EVENT PERMIT—
TO BE RETURNED TO CITY CLERK
S ec ial Event Public Safety and Se Plan
Name of Event: ( S) �u
Location of Event: Pa r
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Cexnicr
Date of Event: - c A 20 � �� Z �
ti. r 1e ID �; 00 4 , ��lie Zl 7 00A)
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Time the Event is to Open:
nn h "S h I Ens CL04Cr Y 7S6CU - W Sail k-, Sponsor of the Event: v�
Estimated Attendance (daily and total): h' "lC i 1� «`I Iu
Emeraency Contact Information:
Name: A Q
I 1 !J tA I
Daytime Phone umber: 2
Cell Number:
Name: l�Gc �
Daytime Phone Number: 9z Z�2 53Dd
Cell Number:
Name:
Daytime Phone Number:
Cell Number:
Primary Location of Event Staff at Event Site:
Emer enc Notification of the Public
The public will be notified of safety and /or security issues in the following
manner:
APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY
CLERK
Emeraency Medical Servic
Name of Provider:
Contact Person I Telephone Number:
Location of Provider at Event Site: —
Fire Protection
Name of Provider:
Contact Person 1 Telephone Number:
Location of Provider at Event Site: —
Number of Fire Extinguishers:
Location of fire access roads:
Securit
Name of Provider:
Contact Person I Telephone Number:
Location of Provider at Event Site: _
Location of Missing Persons Station:
Event Parking Locations:
APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY
CLERK
Severe Weather Contingen
Sh Iter Loc tion
kr
Have You confirmed that the locations will be open and available?
Wh it de rmine if your event is canceled or held? Phone number:
a7 f) 1 IrIAI — qU)
Public Safety Site Plan
Provide a schematic drawing of the event site location. The drawing must be
legible and drawn to scale. The public safety plan must include the following
items if they will be provided, or if they are required.
1. Location of booths, stages, and event structures
2. Location of first aid stations
3. Location of information I ticket booths
4. Boundaries of the event
5. Location of fences nd gates (g ates must be numbered)
6. Location of exits a
7. Location of Fire extinguishers
g. Location of severe weather shelters
g. Location of Fire I EMS access road
10. Location of security staff
11. Location of emergency contact event personnel
12. Location of assembly area and approximate occupant amounts
13. Location of event parking
- 14. Location of barricades
15. Location of generators
16. Location of temporary roadways
APPLICATION FOR SPECIAL EVENT PERMIT
— TO BE RETURNED TO CITY CLERK
Other
Provide any other information that you feel should be considered
0
Yes No
I have reviewed and have considered the Contingency Plan
information provided by the City of Oshkosh along with this
application (pages 11, 12)
1 have reviewed and understand the City's Insurance
requirements for Special Events as described in this document
(pages 13, 14, and 15)
I am enclosing the event's Public Safety Site Plan (see page 9)
I am enclosing other information that I believe is necessary or
helpful to describe the planned event
SIGNATURE
I am allowed to sign this application on behalf of the event sponsor. The
information contained in this application for a Special Event permit is true, correct,
and complete to the best of my knowledge. If there are any changes to the
Spec' I Event, I agree that I will promptly notify the City of Oshkosh of these
C nges and ques approval of them.
1Y Z0l
M C(�rC�1h(�lyU� Date
(print na e) (print title with organization)
APPLICATION FOR SPECIAL EVENT PERMIT —FOR REVIEW ONLY
CONTINGENCY PLAN
Event sponsors should review and consider the following issues when
they are planning or preparing for an event. Many of these issues are required
by one or more regulations, or are components of larger regulations.
Considering other issues which may not be required should contribute to the
planning and operation of the event. Developing responses to these questions
should result in more productive and fruitful discussions with the various
departments with the City during their review of the Special Event Application.
1. Weather related issues: rain, snow, severe storms, tornadoes, etc.
a. If the weather forecast includes bad weather, will the event be cancelled?
If so, how will attendees be notified?
b. Develop a plan for the sudden onset of severe weather. Where will the
people go and who is designated to assist in their safe arrival at the safe
refuge place?
c. Is there an area of safe refuge in case of a tornado?
2. Medical Issues
a. Where will ambulance access to the event be in case one is needed?
b. Who will conduct crowd control in the event of a medical emergency?
C. Will a first aid station, with trained first aid provider, be provided at
the event? Where?
d. If applicable, ? there adequate shade to prevent heat stroke? Will
water be provided? Where?
3. Crowd Control
a. Who will monitor the barricades?
b. Who will work the entry gates? Maintain egress and access?
C. Who will patrol the area to prevent incidents from getting out of
control?
d. Develop a plan for those patrolling the crowd of what to do if they
encounter unruly behavior. Have communications equipment.
APPLICATION FOR SPECIAL EVENT PERMIT— FOR REVIEW ONLY
4. Security
a. Will there be Police Officers providing security? If so, contact the Police
Department for applicable requirements or guidelines relating to the number
necessary.
b. If volunteers or private agencies provide security, will they have appropriate
phone numbers for EMS, Fire, and Police?
c. If applicable, what will security officials do if non - paying attendees breach
the gate or perimeter?
d. If a complaint is received, for example, for loud music, how and who will
handle the complaint?
e. Provide communications equipment. Portable radios, cell phones, and
access to land lines.
f. If applicable, secure monies in an area not accessible to the attendees.
5. Event Logistics
a. Where will there be, or will there be, a staging area for support staff?
b. What time will the crowd be disbursed and by whom?
c. Who will conduct clean up?
d. Remember to maintain fire lanes and access roads.
e. Appoint one person to oversee and take responsibility for the event. Who?
f. Will an adequate amount of restroom facilities be provided? Where?
g. Is there adequate safe parking provided? Where?
Space Intentionally Left Blank
SPECIAL EVENT
INDEMNIFICATION AND HOLD HARMLESS AGREEMENT
(Medium and High Risk Events)
EVENT:
ORGANIZER: S l J Yl I �YS lSU 1 I
�-
T
The event organizer agrees that it, and not the City, will be solely responsible for all incidents related to the
event. This responsibility of the organizer to the City includes but is not limited to the actions of the event
organizer, its officers, employees, agents, and volunteers, along with event vendors, contractors, subcontractors,
participants, and visitors. /� J A s h . y,� p
In consideration for the City's approval of the Special Event, ' I `4 c l
the organizer of this event agrees to indemnify and hold harmless the City of Oshkosh, and its officers, council
members, agents, employees, and authorized volunteers, from, for, and against and agrees to defend the same from
and against, any and all suits, claims, grievances, damages, costs, expenses, judgments and /or liabilities, including
costs of defense and reasonable attorneys fees, and further agrees to pay any settlement entered into or on behalf of,
or judgment entered against, the foregoing individuals and /or entities.
The event organizer shall abide by the City's insurance requirements for the event, including the addition of
the City of Oshkosh, and its officers, council members, agents, employees, and authorized volunteers as additional
insured's for the event.
The individual(s) signing this agreement has the authority to enter into this agreement on behalf of the
organizer(s) of the Special Event.
EVENT ORGANIZE
Flo C Iti12--
(print n me of organizer)
Avg I i 9, zo I l
y (date)
ec
M
(date)
(signature) (title)
name) (print title) (print name) (print title)
Oshkosh Summer Games, 29 Anniversary Games
JUNE 20 -22, 2011
REGISTRATION FORM
SPONSORED BY: ASSOCIATED BANK
COORDINATED BY: OSHKOSH SENIORS CENTER
All persons ages 50+ are invited to participate in as many events as they like. THERE IS A $2.00 NON - REFUNDABLE ENTRY
FEE. Complete this entry form and return along with the entry fee to either Oshkosh Seniors Center North or South Facilities.
REGISTRATION DEADLINE IS WEDNESDAY, JUNE 15, 2011, 4:00 P.M. Registrations will not be accepted after this date
or on -site the day of the events.
*THERE IS A $2.00 NON - REFUNDABLE ENTRY FEE.
(Please print)
DATE OF BIRTH MALE FEMALE
ADDRESS PHONE
(City) (Zip)
YOU MUST CHECK EACH ACTIVITY YOU WANT TO PARTICIPATE IN ON THIS FORM.
MONDAY, JUNE 20
ALL ACTIVITIES WILL
8:30 a.m.
9:00 a.m.
9:30 a.m.
10:00 a.m.
10:30 a.m.
CAKE PLACE AT SOUTH PARK.
WALK FOR FUN
OPENING CEREMONY
SOFTBALL THROW
FRISBEE THROW
TOSS `EM
11:30 a.m. PICNIC LUNCH
12:30 -1:30 p.m. BINGO
1:45 p.m. BEAN BAG TOSS
TUESDAY, JUNE 21
GOLF ACTIVITIES WILL TAKE PLACE AT UTICA GOLF CLUB, 2330 KNOTT RD.
7:00 -8:30 a.m. GOLF (must be finished and scores turned in by 11:00 a.m.)
8:30 a.m. PUTTING
CARD /GAMES WILL TAKE PLACE AT OSHKOSH SENIORS CENTER SOUTH FACILITY, 200 N.
CAMPBELL RD.
1:00 P.M.
SHEEPSHEAD
2:00 p.m.
CRIBBAGE
2:00 p.m.
KINGS IN THE CORNER
3:00 P.M.
SPOONS
WEDNESDAY, JUNE 22
MORNING ACTIVITIES WILL TAKE PLACE ON THE SOUTH PARK LAWN (NEAR TENNIS COURTS)
8:30 -10:30 a.m.
CROQUET GOLF
8:30 -10:30 a.m.
HORSESHOES
8:30 -10:30 a.m.
BOCCI BALL
8:30 -10:30 a.m.
LADDER GOLF
CLOSING CEREMONY WILL TAKE PLACE AT OSHKOSH SENIORS CENTER NORTH FACILITY, 234
N. CAMPBELL RD.
2:30 p.m. CLOSING CEREMONY
PLEASE SIGN THIS RELEASE FORM TO PARTICIPATE:
KNOW ALL PERSONS BY THESE PRESENTS:
That the undersigned hereby declares that he /she has voluntarily agreed to be a participant in SUMMER GAMES 2011 coordinated by the
Oshkosh Seniors Center and fully understands the risks and other ramifications of said participation.
That the undersigned hereby releases the Oshkosh Seniors Center, coordinating groups and Sponsors from all debts, claims, demands,
damages, actions and causes of action whatsoever which may result from said participation in the aforementioned activity and further agrees to hold
Oshkosh Seniors Center, coordinating groups and Sponsors free and harmless from any claim for damages or injury to my person or property
connected therewith. IN WITNESS WHEREOF, I, being of lawful age, have read and understand the terms of this Release and have hereunto set my
hand and seal this day of 201_. SIGNATURE