Application Form To Hold A Special Event (Page 2 of 2) in pdf

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NOTE TO APPLICANT: Please do not complete any information below. Please forward

the application directly to the state park office where the event or activity is to be held.

To obtain the mailing address of specific state parks, visit or call

(614) 265-6561.

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PARK EVALUATION OF PERMIT APPLICATION:

(To be completed by the park manager or designee)

List all division rules that need to be waived by the permit:

______________________________________________________________________________

List any conditions that should be incorporated into the permit:

______________________________________________________________________________

Specific safety-related items: ______________________________________________________

NOTE: Park Manager is to complete and sign only one of the sections below:

For activities that do not require approval of the division chief,

__NO PERMIT REQUIRED (NO FEE CHARGED) BASED ON THE INFORMATION

ABOVE

__________________________

______________

PARK MANAGER

DATE

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__ APPLICATION BEING FORWARDED TO DIVISION CHIEF FOR ACTION

____ event is co-sponsored by the park (waive $40.00 processing fee)

____ add the following amount to the $40.00 permit fee to reimburse park for additional

costs of park security, utilities, etc. AMOUNT: _________

____ recommend denial of permit (submit justification memo)

__________________________

______________

PARK MANAGER

DATE

LIABILITY INSURANCE REQUIREMENTS: If the event requires participants to pay a

registration or entry fee for access to a specific park area where general public access is restricted,

the event sponsor will be required to furnish comprehensive general public liability insurance

covering participants (and spectators) in the amount of $1 million per person, per occurrence for

bodily injury or death. The State of Ohio (and United States of America at Corps of Engineers

facilities) must be named as “additional insured” on the policy and a certificate of insurance must be

submitted to the park at least ten days in advance of the event date. The chief may also require

liability insurance at an event with no admission fee if the event poses a significant risk of injury.

Revised 12/08

Application Form To Hold A Special Event Page 2