JIM STRICKLANDMAYORCITY ATTORNEYPERMITS & LICENSESPARADES AND PUBLIC ASSEMBLIES APPLICATION(Pursuant to City of Memphis Ordinances 4576/Municode 12-52)(The List of Required Information is Attached)(Please print or type)SIDEWALK PARADE: 25STREET PARADE/ONE LANE: 50STREET CLOSURE: 50 (INSURANCE REQUIRED)(ALL APPLICATION FEES ARE NON-REFUNDABLE)SPECIAL EVENT APPLICATIONS MUST BE SUBMITTED 14 BUSINESS DAYS PRIOR TO THE EVENT UNLESS THEEVENT MEETS EITHER OF THE FOLLOWING CRITERIA:SPONTANESOUS EVENT: “Spontaneous events occasioned by news or affairs coming into public knowledge within three(3) days of such public assembly, provided that the organizer thereof gives written notice to the City at least twenty-four (24)hours prior to such parade or public assembly.”ALTERNATIVE PERMIT: “The Permits Office, after consultation with the Director of Police, in denying an application for aparade or public assembly permit, may authorize the conduct of the parade or public assembly at a date, tim e, location, orroute different from that named by the applicant. An applicant desiring to accept an alternative permit shall, within twentyfour (24) hours after notice of the action of the Permits Office, file a written notice of acceptance with the Permits Office.1.Filing Date:2.Is the proposed date of the event at least 14 business days prior to the event? Yes NoIf no, is the event in response to a spontaneous event as defined above? Yes NoIf yes, please complete a Spontaneous Event application.3.Name of Event:Purpose of the Event:4.Name of Sponsor and/or Sponsoring Organization (Applicant):4A. is the Applicant a charitable organization as determined by the IRS? Yes No(If yes, attach a copy of the Applicant’s 501 ((3) (c) determination letters)5.Full Address of Sponsoring Organization:(Street Address)(Telephone #)6.(City/State)(Zip Code)www.(Web)(E-mail)Individual Submitting Application:(Name)(Street Address)(City/State)(Email Address)Rev.04072017/ajh(Home #)(Zip Code)(Place of Employment)Page 1(Work #)

7.Please provide:a.Date of Event:Rain Date:Assembly Time:b. Parade units: Minimum speed (mph):c.Start Time:End Time:Maximum speed (mph):Maximum space (feet) between parade units:d. Portions of streets that may be occupied by the parade or public assembly:e.Maximum length of the parade in miles or fractions thereof:f.Such other information as either the Permits Office or the Police Director shall find necessary to the enforcement ofthis permit (attach any such information).8.What is the specific location of the event?9.List the number of expected participants in this event associated with the Applicant:a. individuals:b. vehicles:c. animals:10. Provide a description of any recording equipment, sound amplification equipment, banners, signs and/or otherattention getting devices to be used in connection with the event:11. When the use of drones, in association with the event is used by the applicant, the applicant must provide DroneLiability Coverage at the time of filing the application which lists the City of Memphis as an additional insured. Theminimum liability coverage is 1,000,000 for personally used drones and 3,000,000 - 5,000,000 for commercially useddrones. Further, Civil/Non-Government Entities, and entrepreneurs flying for business pursuit will need FAAauthorization via Section 333 of the FAA Modernization and Reform Act of 2012 (FMRA). The company may contact theFAA to apply for and be granted an exemption based on their use and need. Only a company holding a commercial useexemption (“333 exemption”), complying with the strict terms of that exemption, and using a licensed pilot may conductcommercial Unmanned Aircraft (“UA” or “drone”) flights. In addition to a 333 exemption, every operator must have aCertificate of Authorization or Waiver (COA) from the FAA covering the parameters of their intended flight. Use of UAor drone flights must be compliant with all federal, state, and local laws and ordinances.Please select the type of Drone usage associated with this application, if any, by checking the appropriate box:PersonalCommercialNot Applicable12. For applicants requesting street closures and/or barricades, explain why they are needed:a.If barricades are to be used, describe the type:b. Provide placement time(s):c.Removal time(s):Identify the individual responsible for placement and removal of any barricades.(Name)(Telephone #)13. Will alcoholic beverages be served at the event either gratis or for sale?YesNo(If alcoholic beverages are to be sold, attach a copy of a permit and/or license for the sale of alcoholic beverages and/or a copy of anyapplication filed and/or to be filed.)14. Submit a copy of any other required approvals, i.e., Park Commission, Riverfront Development Corporation, etc.Rev.04072017/ajhPage 2

REPRESENTATIONS/ACKNOWLEDGMENTSThe Applicant, represented by, agrees to comply with all of therequirements of the Permits Office of the City of Memphis (City) and conditions as set forth above in connectionwith the event,, scheduled for.The Applicant understands that the Memphis Police Department (MPD) may, in its discretion electronicallymonitor the event for the purpose of protecting life and property, providing security and control of eventactivities, and preserving the peace of the City through its law enforcement responsibilities. Any activity of theApplicant arising out of the event resulting in injury, damage or loss to the City is the responsibility of theApplicant. Any overtime costs incurred by the MPD in the exercise of its duties and responsibilities relating tothe event are the responsibilities of the Applicant. City of Memphis ordinances require the Director of Police toensure public safety and to inform an applicant of any estimated additional costs of providing such services forthe event to the applicant in advance of the event. However, the additional charges, by mutual agreement of theapplicant and the City, may be adjusted based on the comparative economic, cultural, social and regional impactof the event on the community-at-large but in no event payment by the Applicant shall exceed twenty-fivepercent of the estimated additional costs when the impact is substantiated. All supportive information must bepresented to the City at least sixty days after the event. Where an Applicant has multiple events during a calendaryear, the statement shall be valid for twelve months from the initial adjustment approval and apply to all saidevents of the Applicant. Further, the Applicant hereby indemnifies and hold harmless the City of Memphis fromany claim, demand, action, suit of any type whatsoever, directly or indirectly, resulting or alleged to haveresulted from the event for which this permit is granted and I,, theApplicant, makes oath that the information contained herein is true and accurate, to the best of my knowledge,and acknowledge that I have read and also agree to all terms and conditions herein set forth.By:(Signature Applicant/Representative)(Date)NOTARYCOUNTY OFSTATE OFBefore me appeared, after having provided proof of identification who affixed their signature to the abovestatement on thisday of, 20.(Notary Public)Rev.04072017/ajh(My Commission Expires)Page 3

PARADES AND PUBLIC ASSEMBLIES APPLICATION REQUIREMENTS1. Obtain one (1) application for each type of event.2. State issued ID is required for applicants applying for any Special Event permit.3. Contact the MPD Special Events Office at 901-636-4640 to determine whether additional police effort will benecessary for traffic control. When possible, without disruption of ordinary police services or compromise ofpublic safety, regularly scheduled on-duty personnel will be available to provide traffic control. If necessary,Police overtime personnel may be used for purposes of traffic control, therefore, you must pay the cost of thisovertime. If you determine that you or the organization are unable to pay such costs, consider an alternative publicforum/venue to conduct the parade, public assembly, or street closure, where there will be no additional cost orless cost to you or your organization. The criteria utilized by the Director of Police Services to determine thepolice resources required, (if necessary) for traffic control will be provided to you at your request.4. Pay a non-refundable fee of 25.00 for special events to cover administrative cost of processing. The fee shall bepaid to the City of Memphis when the application is filed if the parade or public assembly will not require theclosing of public streets or diversion of the normal flow of pedestrian or vehicular traffic with barricades.Street Closures and Block Parties, which require the closing of public streets and diversion of the normal flow ofpedestrian or vehicular traffic with barricades, are available for a non-refundable fee of 50.00.5. Insurance requirement for the street closures:General AggregatePersonal InjuryEach OccurrenceMedical Expense 1,000,000.001,000,000.001,000,000.005,000.00The City of Memphis, its officials, and employees shall be included as an additional insured on the automobileliability and commercial general liability policies as required by written contract. This must be stated on thepolicy.6. Submit a completed application and fees at least fourteen (14) business days prior to the date of the event. TheDirector of Police may waive the minimum (14) business days filing period. If the Director and his designeedetermines that the waiver will not present a hazard despite failure of the public to adhere to the fourteen (14)business days filing requirement, and, if after investigation and consideration of these factors, it is found that thehealth and safety of the public is not compromised and the convenience of the public in the use of the streetsand/or sidewalks would not be unduly disturbed, then the application can be processed. If the event requirestemporary structures in the street, the approved permit must be forwarded to city council lead administrator.7. Submit a hand drawn or pre-printed map to the route of the parade or street closure along with the application.8. Execute the Indemnity and Hold Harmless Agreement.9. Comply with any special directions and conditions deemed necessary by MPD and/or the Permit Office for theissuance of a Permit.Rev.04072017/ajhPage 4

PLEASE BE AWARE OF THE FOLLOWING No permit will be issued if the sole purpose of the event is for advertising. Please contact MPD Special Events - Traffic about the event at 901-636-4640. If the event is in one of the downtown parks, please contact Riverfront Development Corporation for a ParkUsage Permit at 901-312-9190. If the event is in the other city parks, please contact the Park Commission for a Park Lease Agreement at 901636-4251. If the event is on the Mid-America Mall, please contact Downtown Memphis Commission at 901-575-0540. If your event includes outdoor retail sales, please contact Memphis Shelby County Code Enforcement at 901222-8300. If your event is involving Beale Street, please contact Beale Street Merchants Association at 901-529-0999. All permits and agreements need to be with you at all times, failure to produce the documents when asked mayend in the termination of your event. Return Application with the necessary documents to:City of Memphis Permits Office2714 Union Extended, Suite 100Memphis, TN 38112Phone (901) 636-6711Fax (901) 323-9913SPECIAL EVENT OVERTIME COST ADJUSTMENT PROGRAM ELEMENTSThe City of Memphis recognizes the importance of providing monetary and other City support for communityfestivals, parades and celebrations that are held for the general economic benefit of the City’s business community,cultural enrichment and/or promotion of the City of Memphis. In consideration of the beneficial impact of certainevents, the City of Memphis provides Special Event Cost Adjustments to eligible local nonprofit organizations.PURPOSEThe City of Memphis recognizes the importance of local civic events that serve to enrich the lives of local residentsand non-resident participants. The City will adjust certain Special Events fees provided organizations continue tosatisfy cost adjustment provisions. All expenditures in excess of the cost adjustment shall be borne by the sponsoringorganization.PROCESSRev.04072017/ajhPage 5

The cost adjustment will be based upon the economic impact as established by the offset between the revenuegenerated by the event and the cost to the City for providing needed services.A letter requesting a cost adjustment must be submitted by all organizations desiring an Annual Special Event CostAdjustment to the City of Memphis Permits Office no later than thirty (30) days post the first event of the yearsponsored by the organization requesting the cost adjustment and submitted annually. The letter must indicate thefollowing:1. The contact and their contact information for the sponsoring organization.2. The address of the sponsoring organization’s local office/headquarters.3. The event’s mission and/or stated purpose.4. How the event benefits the community of Memphis, TN.5. Any organization not submitting a letter of cost adjustment request by the filing deadline will be ineligible fora cost adjustment in the upcoming calendar year.MINIMUM COST ADJUSTMENTA great deal of time and effort is required of both the Applicant and City staff to complete the cost adjustmentprocess. It is not cost effective for the organization or the City to engage in the cost adjustment process without someassurance of a minimum cost adjustment, if eligible. Therefore, if a cost adjustment is awarded, the minimum awardwill be 1,000.00.Rev.04072017/ajhPage 6

police resources required, (if necessary) for traffic control will be provided to you at your request. 4. Pay a non-refundable fee of 25.00 for special events to cover administrative cost of processing. The fee shall be paid to the City of Memphis when the application is fi