This section collects essential information about your organization and primary liaison. All fields marked as mandatory must be completed for application processing.
Legal Name of Organization
Organization Type
For-Profit Corporation
Non-Profit Organization
Government Agency
Media Production Company
Educational Institution
Other
Tax/Registration Identification Number
Years Organization Has Been in Operation
Organization Website URL
Full Mailing Address of Organization
Primary Contact Full Name
Primary Contact Title/Position
Primary Contact Email Address
Primary Contact Direct Phone Number
Alternative Contact Person Name and Title
Brief Description of Organization's Primary Activities and Purpose
Has your organization previously conducted events or filming on academic institution properties?
Professional References from Similar Past Events (if available)
Reference Organization Name | Contact Person | Email Address | Phone Number | Event Date | Nature of Event | |
|---|---|---|---|---|---|---|
Provide precise details about your proposed event or production. Specificity is crucial for risk assessment and logistical coordination.
Event or Production Title
Detailed Description of Event or Production Purpose
Primary Category of Request
Commercial Filming (Cinematic/Streaming)
Promotional Video Production
Photography Session
Conference/Symposium
Concert/Performance
Festival/Carnival
Sporting Event/Competition
Corporate Meeting/Retreat
Other
Specific Campus Location(s) Requested
Proposed Setup/Load-in Start Date and Time
Actual Event/Filming Start Date and Time
Event/Filming End Date and Time
Proposed Breakdown/Load-out Completion Date and Time
Total Expected Attendance (participants, crew, audience, etc.)
Will any portion of this event be open to the general public?
Will alcohol be served or consumed as part of this event?
Will amplified sound (speakers, microphones, musical instruments) be used?
Will open flames, pyrotechnics, or special effects be utilized?
Will the event involve visual or audio recording of campus property, staff, or students?
Comprehensive Equipment Inventory and Technical Requirements
Equipment Item Description | Quantity | Power Requirement (Watts) | Setup Duration | Special Handling or Safety Notes | |
|---|---|---|---|---|---|
Accessibility Accommodations and Inclusive Measures Planned
Detail your comprehensive safety and security strategy. This information is critical for protecting all participants, property, and the campus community.
Designated Safety Coordinator Full Name
Safety Coordinator Direct Contact Number
Emergency Action Plan Summary
Will licensed medical personnel (EMT, paramedic, nurse) be on-site?
Crowd Management and Control Strategy
Number of Professional Security Personnel to be Deployed
Licensed Security Company Name (if applicable)
Will this event require road closures or traffic detours?
Will dedicated parking areas be required for participants or equipment?
Communication Plan with University Administration During Event
Upload Comprehensive Risk Assessment Document
Adverse Weather Contingency Plan
Will minors (under 18) be present at this event?
Identify All Potential Special Hazards Associated with This Event
None identified
Heavy equipment operation
Working at heights
Hazardous materials
Water-based activities
Animals/livestock
Food service/catering
Large-scale electrical distribution
Temporary structures (tents, stages)
Other
Post-Event Cleanup and Site Restoration Plan
Provide comprehensive insurance documentation. Inadequate insurance coverage will result in automatic application rejection. All policies must be valid through the entire event period.
Insurance Provider Company Name
Insurance Provider Contact Email
Insurance Provider Contact Phone
General Liability Policy Number
General Liability Coverage Amount (minimum typically required: $1,000,000)
Policy Effective Date
Policy Expiration Date
Upload Certificate of Insurance (COI) - Must name University as Additional Insured
Does your policy specifically name this University as an Additional Insured?
Does your policy include coverage for Property Damage to third-party premises?
Does your policy include coverage for Personal and Advertising Injury?
Do you carry Workers' Compensation Insurance covering all personnel who will be on-site?
Do you carry Commercial Auto Liability Insurance for vehicles used in connection with this event?
Do you have Umbrella or Excess Liability Coverage?
Describe Any Special Insurance Endorsements or Coverage Extensions Relevant to This Event
I hereby agree to indemnify and hold harmless the University, its officers, employees, and agents from any and all claims, damages, or liabilities arising from my organization's activities on campus property.
I understand that the University reserves the right to require higher insurance limits based on risk assessment findings.
I certify that all insurance information provided is accurate and policies are currently active.
This section acknowledges the university's review authority and finalizes your application submission. All declarations must be completed by an authorized representative of your organization.
REVIEW PROCESS: Upon submission, your application will undergo comprehensive review by the Office of University Events, Risk Management, Campus Safety, Facilities Management, and other relevant departments. This process typically requires 15-30 business days. Complex events may require additional review time. You will be contacted if supplemental information is needed.
I acknowledge that submission of this form does not constitute approval or permission to access campus property.
I understand that all plans are subject to modification requirements based on university safety and operational standards.
I agree to pay all applicable facility rental fees, security charges, and any other associated costs as determined by university fee schedules.
I commit to providing final participant counts, vendor information, and updated insurance certificates no later than 10 business days prior to the event.
I understand that the University reserves the right to cancel approval at any time due to unforeseen circumstances, safety concerns, or policy violations.
I declare under penalty of perjury that all information provided in this application is true, accurate, and complete to the best of my knowledge.
Full Name of Authorized Signatory
Title of Authorized Signatory
Digital Signature of Authorized Representative
Signature Date
Additional Comments or Special Considerations for University Review Committee