APPENDIX A: MORGAN COUNTY MASS GATHERING APPLICATION FORM
Dear Event Organizer:
If you are planning an assembly of any kind that will reasonably be expected to be attended by more than 5000 individuals and be more than 18 hours in duration, you are required to obtain a mass gathering license for each day your event will take place, in accordance with I.C. 16-41-22 and County Code of Ordinances, Chapter 93.
   Directions
The permit application process begins with you submitting a completed mass gathering permit application and required attachments, including a detailed map/diagram of your event.
Please note that acceptance of a completed application does not guarantee approval of an event. Upon submittal of your application, copies are forwarded and reviewed by various departments within Morgan County. As part of the approval process you may be required to provide additional information and/or documents (i.e., certificate of insurance, secondary permits, and the like). The mass gathering permit will not be issued until the required conditions (where applicable) are satisfied. Delays in providing information and/or documentation will delay the approval process.
If the event involves the use of a facility or property that does not belong to Morgan County, it is the applicant’s responsibility to contact the appropriate entity regarding the availability and use of the property.
1.   Submit your completed application (with five complete copies) at least 60 days before your proposed event with a check made payable to Morgan County Commissioners for $200 for a mass gathering license. This processing fee is non-refundable.
2.   You will be sent an acknowledgement that your application has been received. Your application will then be reviewed by various county agencies. During this review period, you may be contacted by county representatives for clarification of your event details.
3.   After a full review of your application, the Sheriff shall cause to be delivered, either a denial letter or a conditions of approval letter. The conditions of approval letter will outline requirements for your event, such as necessary permits, approvals, and/or applicable fees.
4.   Once all the conditions of approval have been met, a “mass gathering permit” will then be issued by the Morgan County Sheriff. You will be required to have this permit in possession during your event.
We appreciate your time and interest in planning a successful and safe event in Morgan County. If you need blither assistance, please call                                                                .
SECTION 1:   GENERAL INFORMATION
Today’s Date:                                                 Event Title:                                                            
Event Location:                                                                                                                            
Name of Property Owner:                                                                                                             
Address of Property Owner:                                                                                         
Phone Number of Property Owner:                                                                                                
Name of Mass Gathering Operator:                                                                                                
Address of Mass Gathering Operator:                                                                                             
Phone Number of Mass Gathering Operator:                                                                                   
Day-of-Event Contact:                                           Day-of-Event Phone:                                        
Please provide a description of your event, including activities, timeline, and sequence of events. Include in your response what steps will be taken to limit the number of people in attendance to the maximum permitted in accordance with the license issued, if such license if issued; and all other information you believe relevant.
_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
                                                                                                                                              
SECTION 2:   LIABILITY
Insurance/Indemnification Requirements
Insurance required. General liability, automobile liability, workers comp/employer’s liability, comprehensive form, including liquor liability (where applicable) in the amount of $1,000,000 per occurrence, naming Morgan County as additional insured. Sponsor shall furnish original certificates of insurance and separate attached additional insured endorsements (affecting coverage required by the change) signed by a person authorized to bind coverage on its behalf.
Bond Requirements
Bond required. The applicant shall file a bond with the Clerk of the Morgan Circuit Court, with said bond meeting the following conditions:
   a.   Be either in cash or underwritten by a surety agent licensed to do business in Indiana;
   b.   Be issued at the rate of $4 per person for the maximum number of people permitted to assemble;
   c.   Indemnify and hold harmless the unit or the unit’s agents, officers, or employees from any liability or causes of action that might arise by reason of granting the license and from any cost incurred in cleaning up any waste material produced or left by the assembly;
   d.   Guarantee the state the payment of any taxes that accrue as a result of the gathering;
   e.   Guarantee reimbursement to ticketholders if the event is canceled; and
   f.   Guarantee to the county, or any other unit of government as applicable, repayment for actual expenses of repair or replacement of property owned by the unit or for which the unit is responsible.
Hold Harmless and Indemnification Agreement
The licensee shall defend, indemnify, and hold harmless Morgan County, its officials, employees, agents, and volunteers from any and all claims, injuries, damages, losses or suits, including attorney fees, arising out of or in connection with the event that is the subject of this application and license. The undersigned affirms that he or she has the authority to agree to this hold harmless and indemnification clause, either in his or her capacity as an individual or on behalf of the entity submitting this application.
Signature:                                                                                          Date:                                   
Please Print Name:                                                                             Title:                                   
SECTION 3:   EVENT INFORMATION
Setup/Preparation Date:                      Time:                 Event Ends Date:                     Time:              
Event Start Date:                     Time:                   Dismantle Date:                       Time:                      
Anticipated Attendance: Total:                Per day:                 
Will this event be open to the public? Yes               or No                
Location of the event (please be specific) If privately owned property, attach proof of approval from property owner (and tenant).
                                                                                                                                                         
Zoning Classification:                      
County Facilities
Do you plan to hold your event at a county building or park? Yes                or No                 
If you answered yes, what facility:                                                                                           
Have you reserved the facility yet? Yes                 or No                     
Is this event a block party? Yes               or No                    
Will this event require any town/county sheets to be closed? Yes                or No                     
If yes, which streets (please specify cross-streets)? Include a route site map.
Will you have off-site parking? Yes                      or No                     
If yes, please attach a statement from the property owner of the off-site parking acknowledging and approving the use of their property for parking.
Does this event involve a parade? Yes                      or No                     
Does your event include food concessions and/or preparation areas? Yes                      or No                     
If yes, please describe how food will be served and prepared. Include a copy of permit horn Morgan County Health Department.
                                                                                                                                                           
                                                                                                                                                           
 
Specify cooking method:                 Gas                  Electric                  Charcoal                  Other (specify)
Enclosed Restroom Facilities
You are required to provide enclosed restroom facilities at this event and meet all federal, state, and local requirements related thereto. There must be at least one restroom for every 150 women and at least one restroom for every 200 men anticipated to attend the event.
Do you plan to provide portable restroom facilities at your event? Yes                   or No                     
If yes, total number of portable toilets:                   Number of ADA-compliant portable toilets:                
Lighting
Will this event use any lighting? Yes                   or No                  
If this event is an evening event, please state how the event and surrounding areas will be illuminated to ensure the safety of the participants and spectators.
                                                                                                                                                        
                                                                                                                                                           
Electrical Access
A licensed electrician must be used for all electrical work associated with the event.
Electricians Name:                                                                                                                             
License Number:                                                                                                                               
Phone:                                                            Email:                                                                        
Mailing Address:                                                                                                                               
Day-of-Event Contact:                                       Day-of-Event Phone:                                                   
Medical/First Aid Services
Are you planning to provide on-site first aid: Yes                 or No                  
If yes, please list who will be providing first aid services (examples: EMT, paramedic, registered nurse) and proof of the same.
Provide contact information:
                                                                                                                                                        
                                                                                                                                                         
Please describe your emergency medical plan, including your communications procedures:
                                                                                                                                                        
                                                                                                                                                         
Security
Are you planning to provide on-site security? Yes                   or No                  
If yes, please list who will be providing said security services and proof of the same.
Provide contact information:
                                                                                                                                                        
                                                                                                                                                         
Please describe your security plan, including crowd control and contact information:
                                                                                                                                                        
                                                                                                                                                         
Event Promotion
Will this event be promoted, advertised, or marketed in any manner? Yes                 or No                  
If yes, please explain:
                                                                                                       
                                                                                                                                                         
Will any signs, banners, decorations, or special lighting be used? Yes                 or No                  
If yes, please explain:
                                                                                                                                                        
                                                                                                                                                         
Sound/Noise
Will you be using any amplified sound (i.e. public address system P.A.)? Yes             or No              
If yes, please describe, and include what measures will be taken to abide by the hour restriction on sound as well as what limitation is planned for lighting and whether the lighting will affect any adjacent property owners or others:
NOTE: Limit amplified sound use from 6 a.m. to 11 p.m. Event organizers must be certain that all event activities comply with the local laws applicable to noise abatement,
Is there any musical entertainment related to your event? Yes                   or No                  
Date:                   from                   AM/PM to                   AM/PM
Date:                   from                   AM/PM to                   AM/PM
Date:                   from                   AM/PM to                   AM/PM
Date:                   from                   AM/PM to                   AM/PM
Sound amplification:
Date:                   from                   AM/PM to                   AM/PM
Date:                   from                   AM/PM to                   AM/PM
Date:                   from                   AM/PM to                   AM/PM
Date:                   from                   AM/PM to                   AM/PM
NOTE: If multiple groups, bands, and the like will provide musical entertainment, please provide contact name, telephone number and address for each and attach to this application.
Group Name:                                                                                                                                   
Contact Person’s Name:                                                                                                                    
Phone Number:                                                Cell Phone Number:                                                   
Contact Person’s Address:                                                                                                                 
Number of stages:                   Height:                   Depth:                   Width:                   Number of
Bands:                  
Describe sound equipment that will be used:
 
Will sound checks be conducted prior to the event? Yes                   or No                  
If yes, please list the date and times: Date:                   from                   AM/PM to                   AM/PM
Will aerial fireworks, theatrical pyrotechnics or other regulated special effects be used?
Yes                   or No                  
If yes, please describe:
                                                                                                                                                        
                                                                                       
Name of pyrotechnic company:                                                                                                        
Phone Number:                                                   Company Contact:                                                 
Title:                                                       Operator:                                                                        
License No.:                                                                                                                                  
Notification
You may be required to notify surrounding residents, businesses, organizations, and the like that may be impacted by your event.
As a condition of the event, you may be required to provide a copy of the notice and proposed list of recipients.
Advance Cancellation Notice Required
If this event is cancelled, notify the Board of Commissioners and/or the Sheriff at least 48 hours in advance.
Miscellaneous
Will anything be sold? Yes                   or No                  
If yes, please describe
                                                                                                                                                        
Will donations be taken at event? Yes                   or No                  
If yes, please describe:
                                                                                                                                                        
                                                                                                                                                         
Will this event involve a car wash? Yes                   or No                  
If yes, please describe:
                                                                                                                                                        
                                                                                                                                                         
Will you be using a tent, stage, canopy, or other temporary structure? Yes                   or No                  
If yes, please describe - include size of structure (square feet) and what you plan to do inside the structure:
                                                                                                                                                        
                                                                                                                                                         
In order to comply with the American with Disabilities Act, describe how your event will be accessible to people with disabilities:
                                                                                                                                                        
                                                                                                                                                         
Please describe your plan for cleanup and removal of recyclable goods and garbage during and after your event:
                                                                                                                                                        
                                                                                                                                                         
SECTION 4:   SITE MAP
Please provide a site plan/route map for your event. Attach additional sheets, as necessary. The map should include:
                 An outline of the event site including the names of streets or areas that are part of the venue and the surrounding area. If the event involves a moving route of any kind (such as a parade), indicate the direction of travel, including the starting location and ending destination.
                 Any street or lane closures and parking tow zones.
                The locations of fencing, barriers, or barricades. Include any removable fencing for emergency access.
                 The location of first-aid facilities
                 The location of all stages, platforms, booths, cooking areas, trash containers, tents/canopies, and the like.
                 Food booths and cooking area configuration including all vendors cooking with flammable gases or barbeque grills.
                 Generator locations and/or source of electricity.
                 Placement of vehicles or trailers used for the event.
                 Anticipated parking locations. ADA parking locations.
                 Placement of promotional signs or banners. (Please see Director of Planning for sign permits).
                 Placement of portable toilets/restrooms facilities.
                 Exit locations for outdoor events that have fences.
                 Event headquarters/command post.
                 Lost child station.
                 Booths, tents, canopies, exhibits, displays, enclosures.
                 Stages, platforms, scaffolding, bleachers, grandstands, or related structures.
                 Rides and amusements (games).
                 Trash containers/dumpsters/recyclable containers.
                 Locations of all other event activities.
                 Potable water
                 Lighting location(s)
                 Telephone service
                 Camp sites
                 Fire protection
                 Parking area with traffic flow pattern
                 Are admissions, vendor, or other fees required? Yes                   or No                  
If yes, please provide admission fees:
Adult $                  Senior $                  Child $                 
Vendor fees: For profit $                  Non-profit $                 
Number of vendors:                  
How many vendors for profit?                  
How many vendors for non-profit?                  
Other fees: Yes                   or No                  
Describe:                                                                                                                                           
                                                                           
                                                                                                                                                         
All vendors must possess one of the following: 1) transient merchant license, 2) peddler license or 3) solicitor license with Morgan County. This business license must be displayed at all times during the event. Please list all Vendors and their business license numbers on the attached sheet.
Vendor List (attachment) make additional copies of this page if necessary.
For each merchandise vendor, please complete the information on the following page:
Vendor Name:                                                  
Address:                                                          
Phone/cell #                                                     
Business license #                                             
Type of Merchandise:                                       
Vendor Name:                                                  
Address:                                                          
Phone/cell #                                                     
Business license #                                             
Type of Merchandise:                                       
Vendor Name:                                                  
Address:                                                          
Phone/cell #                                                     
Business license #                                             
Type of Merchandise:                                       
Vendor Name:                                                  
Address:                                                          
Phone/cell #                                                     
Business license #                                             
Type of Merchandise:                                       
 
Vendor Name:                                                  
Address:                                                          
Phone/cell #                                                     
Business license #                                             
Type of Merchandise:                                       
Vendor Name:                                                  
Address:                                                          
Phone/cell #                                                     
Business license #                                             
Type of Merchandise:                                       
Vendor Name:                                                  
Address:                                                          
Phone/cell #                                                     
Business license #                                             
Type of Merchandise:                                       
Vendor Name:                                                  
Address:                                                          
Phone/cell #                                                     
Business license #                                             
Type of Merchandise:                                       
 
 
AFFIRMATION STATEMENT
I certify that the information contained in the foregoing application is true and correct to the best of my knowledge and belief, that I have read, understand and agree to abide by the rules and regulations governing the mass gathering events under Morgan County Code, and that I understand that this application is made subject to rules and regulations established by Morgan County Board of Commissioners. I agree to comply with all permit conditions and with all other requirements of the county, state and federal governments and any other applicable entity that may pertain to the use of the event premises and the conduct of the event. I agree to abide by these rules and further certify that I, on behalf of the organization, am also authorized to commit that organization and therefore, agree to be financially responsible for any costs and fees that any be incurred by or on behalf of the event to Morgan County.
Date:                                                  
Applicant Printed Name:                                                  
Applicant Signature: