Current Page 1 Page 2 Complete Date of Party: Start time: End time: Possible rain out date: Block party organizer(s) / applicants: Name: Address: Phone: Email: Name: Address: Phone: Email: Name: Address: Phone: Email: Barricades and signage are to be placed in front of: House Number House #: and House Number 2 House #: House Number 3 House #: and House Number 4 House #: You must have permission from 75% of the neighbours who are affected by the street closure. Please include the completed “Permission to Block the Street” form (on Page 2) with this application. It is the sincere desire of the Township of Tiny to have all activities conducted in an orderly manner. Applicants granted a Block Party are requested to cooperate to ensure that this can occur. Cooperation and control of foul language and bad conduct are expected. Township Staff acts under the authority of the Township of Tiny and should be given the support and cooperation of all Block Party Organizers/Participants. By signing the Block Party Application and Waiver, you acknowledge, understand and agree to the terms and conditions set forth.Terms and ConditionsThe Applicant(s) must comply with all guidelines outlined in the Block Party Program.The Applicant(s) must review the Block Party Planning Guide available at www.tiny.ca.The Applicant(s) will be responsible for arranging tables for food, BBQs, coolers, and clean-up at the end of the event. The Applicant agrees to remove garbage and equipment following the event and leave the street/municipal property in the same condition it was received. The street/municipal property is to be vacated within one hour of the time indicated on the application.The Applicant(s) is responsible for any loss or damage to barricades or signage.When setting up tables and chairs, the applicant(s) will ensure that emergency vehicles have access to the street.Alcohol is only permitted on private property, NOT on Township streets or municipal property (i.e. parks). Loud amplification of music is prohibited. Municipal By-law Enforcement will be informed of the Block Party and will patrol periodically and at its discretion.The Township of Tiny will not be responsible for injury or damage or for the loss or theft of any personal belongings or equipment of the Applicant(s) or organization, or anyone in attendance at the event. All merchandise supplied and/or equipment used by or for the Applicant shall be at and remain solely at the Applicant’s risk. The Township of Tiny shall not be responsible for the care or safekeeping thereof or any damages thereto by any cause whatsoever, unless expressly provided in writing.The undersigned agrees to indemnify the Corporation of the Township of Tiny of all claims arising in relation to the Block Party Program provided such claims are not caused by the negligence of the Township of Tiny. The undersigned further agrees to be bound by this application and the Terms and Conditions contained herein and attached hereto, and hereby warrants and executes this event on behalf of the organizing group and has sufficient power, authority and capacity to bind the applicant(s) with his/her signature. The Township of Tiny hereby grants permission to hold a Block Party as outlined, subject to the Guidelines of this Program contained herein and attached hereto, all of which form part of this Agreement. Signature of block party organizer: Sign above Dated: Signature of Community Engagement Coordinator: Sign above Dated: