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Sponsoring Organization:______________________________
Is this a non-profit organization? -Yes -No
Sponsor Address (Return Address):______________________________
Contact Person:______________________________
Contact Person Address (Return Address):______________________________
Phone # (Home):____________________ Phone # (Cell):_____________________ Phone # (Work):____________________
Email:______________________________
Name of Event:______________________________
Type of Event Activity:______________________________
Date(s) of Event:______________________________ Time of Event (start and finish):______________________________
Is there a fee charged to participants? -Yes -No -If Yes, fee amount: $
Is there a fee charged to spectators? -Yes -No -If Yes, fee amount: $
Number of Participants:____________________
Number of Participating Boats (if applicable):____________________
Number of Monitoring/Safety Boats (if applicable):____________________
Number of Spectators (if applicable):____________________
Number of Spectators Boats (if applicable):____________________
Corps Project / Proposed Location of Event:______________________________
Location of Water to be Used (nearest river mile):______________________________
With full knowledge and understanding of the risks involved, I agree to hold the U.S. Army Corps of Engineers, the Federal Government, and agency of the Federal Government, officers, agents, servants, employees and contractors of the U.S. Army Corps of Engineers/Federal Government harmless for any damage to property or injury to persons resulting from the event.
Date:____________________
Signature of Sponsor's Representative:_________________________________
* Before submitting read & print a copy of the Special Event Guidelines and Conditions
***DO NOT COMPLETE BELOW THIS LINE***
APPLICATION STATUS
Date Received:____________________
Payment Amount Included:______________
____Approved ____Denied ____Incomplete Information
Reviewing Officials Signature:____________________________________
Special Events Permit Number(s):____________________ Special Events Permission Number(s):____________________