Applicant Certification (required): *
I hereby certify that I have read this application and that all information contained herein is true and correct to the best of my knowledge, information and belief. I agree to comply with all Statutes, County and City Ordinances, and the general instructions stated in this application and the special conditions issued by the City in connection with the approval of the Special Event contemplated herein. I, and the organization on whose behalf I make this application, if any, represent, stipulate, contract and agree that we will, jointly and severally, defend, indemnify, save and hold the City harmless from any and all claims, lawsuits, judgments, and liability for death, personal injury, bodily injury, or property damage arising directly or indirectly from the exercise of the Special Event Permit and performance of the Special Event by Applicant, the organization represented by Applicant, its employees, subcontractors, or assigns, including acknowledges that he/she, together with any organization represented by Applicant, shall be solely responsible by complying with the terms of the Permit. I further understand that failure to comply with any of the provisions specified herein, or the unauthorized modifications of any event parameter, may result in immediate cancellation of this event by City officials. Applicant must be 18 years of age or older. The non-refundable application processing service fee must be submitted at the time of application. Please make all checks payable to the City of Clearwater. If you have questions, please call 727-562-4805.