LOUDOUN COUNTY PUBLIC SCHOOLS Procurement Services

21000 Education Court, Suite #301 Ashburn, VA 20148

Phone (571) 252-1270 Fax (571) 252-1432

LCPS Special Events Guidelines and Application A. Who Sponsors Special Events Involving LCPS?

Schools/Educational Groups PTA/PTO/Booster Organizations Church Organizations

Civic, Community, & Governmental Groups Athletic Organizations & County Parks & Rec. Non-Profit Organizations

B. LCPS Special Event Instructions Step 1. 60 days prior to the event: The Event Organizer shall submit a simple written proposal to the School

Administration, outlining the “who, what, when, where, how, and why” details of the requested special event.Non-School Groups wishing to host an event on school property must submit a Facility Use Request Form to the School Administration for approval a minimum of 60 days prior to the event date.

Step 2. 30 days prior to the event: If the School Administrator approves moving forward, the Event Organizer shall complete and submit the LCPS Special Event Application to LCPS Procurement Services. All documents shall be emailed as PDF attachments to Kelly.Briner@lcps.org AND Dawn.Taylor@lcps.org IMPORTANT: LCPS Special Event Applications MUST be received in Procurement a MINIMUM OF 30 DAYS PRIOR TO THE EVENT DATE to ensure timely processing.

C. Who Approves Special Events Involving LCPS? All Special Events involving LCPS shall be approved by the relevant LCPS Principal/Administrator prior to moving forward. LCPS Procurement Services shall review all LCPS Special Event Applications and shall refer unusual activities to the appropriate LCPS Director of Education for final approval. LCPS Procurement Services’ role is to provide advice regarding risks, review contracts for liability, identify and assist with necessary Permit and Insurance requirements, and monitor all special events involving LCPS, whether on or off of school property.

D. Special Events Vendor/Contractor Services include, but are not limited to, the following:

Amusement Rentals including mechanical carnival rides, inflatables (moon bounces, obstacle courses, etc.),dunk tanks, carnival games, snow cones, cotton candy, etc.

Animal Exhibitions-Reptiles, Birds, Canines, Kissing Pigs, Petting Zoos, Farm Animals, etc. Caterers, Restaurants, Mobile Food Vendors, etc. DJs, Entertainers, Magicians, Face Painters, Dancers, Artists, Athletic Exhibitions, BMX Bike Shows, etc. Photo Booths, Planetariums, Inflatable Movie Screens, Light Shows, etc. Fundraising Organizations-Selling Food Products, Merchandise, Subscriptions, School Supplies, etc. Speakers and Presenters-Authors, Educators, Comedians, Motivational Speakers, etc. Music, Theatre, and Dance Performing Groups Equipment Rental for Parties and Ceremonies (stages, platforms, casino tables, tents, stairs, etc.) 1K-5K-10K, etc. Race Events—Event Planners, Race Course Certification, Race Timing and Management Firms

E. Vendor/Contractor Agreements for Special Events Involving LCPS—Any Special Event involving LCPS (before, during, or after school and on or off of school property) creates liability for the School System. 1. All Vendor/Contractor agreements involving LCPS shall be sent to LCPS Procurement Services for review prior

to making a commitment. Any contracts involving LCPS and PTAs, PTOs, Boosters, Community Groups, etc. shall also be sent to LCPS Procurement Services.

3. LCPS will not agree to the following contractual provisions and will request removal from the vendor’s contract:

a. Hold Harmless, Indemnification, Waiver or Limitation of Liability, Assumption of Risk, etc.b. Additional fees/charges based on Audits following the delivery of servicesc. Payment of Attorneys’ fees

LCPS Procurement Services/Risk Management Office 9/2/15 edition

2. Events/Activities involving students and scheduled during the school day are generally considered SchoolSponsored Events and require contracts to be in the name of the school and a School Administrator's signature.

d. Personal Guarantee by the Signer of the Contracte. Binding Arbitrationf. Legal Jurisdictions other than the Commonwealth of Virginiag. Responsibility for Repairing or Replacing Vendor’s Propertyh. Automatic Contract Renewals

F. LCPS Annual Requirements for Vendors/Contractors—The following documents are required for approval of all Vendors/Contractors providing services on School property or on behalf of LCPS.

Contractors Certification Form Virginia Mandatory Contract Provisions Certificate of Liability Insurance W-9 Tax Payer Identification Form

These documents must be updated annually (or upon expiration) and will allow Vendors to contract with any School/Department desiring their services. Please contact LCPS Procurement Services at 571-252-1270 to check on the Vendor’s document status. Vendors/Contractors may also visit this link LCPS Vendor Registration for further information or to register.

G. Special Event Permits— PERMITS are required based on State and local ordinances. See the LCPS Special Events Application for details on required permit documents. LCPS Procurement Services manages the permit process and will assist the Event Organizer. IMPORTANT: LCPS Special Event Applications MUST be received a MINIMUM OF 30 DAYS PRIOR TO THE EVENT DATE.

Loudoun County-For more information on Loudoun County’s event planning and permit requirements, visit their website at http://www.loudoun.gov/index.aspx?nid=827. If the special event is open and advertised to the general public, involves a large number of attendees, or has the need for public safety or security, the Event Organizer should complete the Loudoun County Special Event Registration on line at this link http://interwapp01.loudoun.gov/repi/eventRequest.aspx. The Loudoun County Office of Emergency Management will respond to the Event Organizer with instructions on how to proceed with notifying and complying with the various agencies affected by the event.

H. Restricted LCPS Events and Activities—The following events/activities are not recommended for sponsorship by LCPS without prior written approval from the appropriate LCPS Director of Education (Elementary, Middle, High School, Technical Ed, etc.). LCPS does not carry liability or medical accident insurance for these activities and the inherent risks involved. If approval is granted by the appropriate administrator, Procurement Services will assist with insurance requirements and recommend measures to minimize liability.

Airplane Rides or Air Show Exhibitions All-Terrain Vehicle (ATV) Rides Amusements-No Demo Ball, Wrecking Ball, Rock Walls, Trampolines, Slingshots, Sumo Wrestling, Bouncy Boxing, Students in Dunk Tanks, Joust, Laser Tag-No activities that are combative or involve shooting at others Animals—Professional Animal Exhibitions and Petting Zoos are allowed with prior approval and liability insurance. Certified Assistance Animals are allowed as required by law. No family or volunteer pets. Athletic Activities open to General Public Participation—Including Road Races (5K runs), Dodge Ball, Tug of War, Basketball, Volleyball, and other Athletic Tournaments. School Community Fun Runs/Walks on School property are allowed. Aviation Activities including Airplane/Helicopter Rides, Hot Air Ballooning, Glider Flying, Hang Gliding, Parasailing, Sky Diving or Exhibitions

Bicycle Riding or Racing Boating—unless provided by a commercial firm with liability insurance Bob-sledding Boxing or Bouncy Boxing Bungee Jumping or Trampolines Canoeing—unless provided by a commercial firm with insurance Car or Truck Smashing Fundraisers Catapults or Sling Shot Devices Circus Sponsorship Climbing Walls—Hard or Soft—No Climbing or Rappelling requiring a harness Cow Chip Bingo or Meadow Muffin Fundraisers Cruises—unless provided by a commercial firm with insurance Demo Ball-Inflatable Amusement

LCPS Procurement Services/Risk Management Office 9/2/15 edition

Restricted LCPS Events and Activities… Dodge Ball Dogs—Therapy Dogs unless provided by a commercial or nonprofit firm with liability insurance and preapproved. Certified Assistance Dogs are allowed. No family or volunteer pets. Dog Wash Donkey Basketball Fencing or Sword Play Fighting or resemblance of hand to hand combat—No Bouncy Boxing, Sumo Wrestling, Gladiator Joust, Rock’em Sock’em, etc. Fire—Pyrotechnics, Candles, Open Air Fires Fireworks Displays Flying or Rigging Actors for Drama/Theatrical Productions Fog Machines—without prior approval from LCPS Safety & Security Gas or Propane powered equipment inside School facilities Gelatin, Mud, Pudding, or Sumo Wrestling Gladiator Joust Glider Flying Hang Gliding Helicopter Rides Horseback Riding Hot Air Ballooning or Exhibitions Hypnotist Exhibitions or Fundraisers without review and prior approval Ice Hockey or Ice Skating Inflatables—No Demo Ball, Wrecking Ball, Laser Tag, Rock Walls, etc. Jousting Kayaking Laser Tag or Paint Ball Martial Arts—professional demonstrations or exhibitions are allowed with prior approval Mechanical Rides—No Human Whirl, Gyroscope, Tumbler; Soft Mechanical Bull is allowed at level 2 and below Motorcycle Rides or Car Racing Paint Ball Parasailing Parties on Watercraft—unless provided by a commercial firm with insurance

Petting Zoos—unless provided by a commercial or nonprofit firm with insurance Pie Throwing Pony Rides—unless provided by a commercial firm with insurance Pyrotechnics-flash pots, flames, candles, etc. Rafting or Tubing Rock Face or Wall Climbing and Rappelling Rocket Launching-(except approved LCPS Science or Tech. Ed. Programs) Rodeos Ropes Courses—unless provided by a commercial firm with insurance Sailing Scooter Boarding Scuba Diving Shooting or resemblance of weapons or toy guns—Laser Tag, Pointless Paintball, Water Gun Tag, etc. Skateboarding, Rollerblading, Scooter Boarding or Wave Boarding Sky Diving or Exhibitions Sling Shot or Catapult Devices Snow Skiing, Snow Boarding, Sledding, Bob-sledding Sumo Wrestling Surfing Swimming Pool Parties (except at a commercial facility with lifeguards) Tattooing Theatre—Stage Rigging for Flying or Elevating Actors Trampolines or other rebound devices—Extreme Air Jumpers, Bungee Jumping, etc. Tubing or Rafting Tug of War or use of ropes/cords Water Activities—Boating, Canoeing, Kayaking, Sailing, Tubing, Whitewater Rafting, Water Skiing, Surfing, Scuba Diving, Snorkeling, or Parties on Watercraft Water Balloons-Fights or Water Tag Whitewater Rafting Wrecking Ball Inflatable Wrestling—Gelatin, Mud, Pudding, Sumo Zip Lines and Ropes Courses—unless provided by a commercial firm with liability insurance

LCPS Procurement Services/Risk Management Office 9/2/15 edition

LCPS Special Event Application 9/2/15 Page 1 of 4

PROCUREMENT SERVICES USE ONLY

Location at LCPS Facility: Off-Site Location:

Event Date: Event Time:

Event Name:

Loudoun County Public Schools Special Event Application

Refer to the LCPS Special Events Guidelines.

E-mail this completed application and required documents as PDF attachments to LCPS Procurement Services,Kelly.Briner@lcps.org AND Dawn.Taylor@lcps.org. Call 571-252-1270 with any questions.

Submit all information a MINIMUM of 30 days prior to the event date.

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1. School/LCPS Site Name: 2. Today’s Date:

3. School Employee Contact Name: 4. Title:

5. Event Location Name, if off site:

6. Off-site Event Address/City/State/Zip:

NOTE: If this Application is for a School Sponsored Event, skip to #22 and continue completing the application. Events/ Activities involving students and scheduled during the school day are generally considered School Sponsored events.

7. Name of Organization Sponsoring Event:

8. Address: 9. Phone #:

10. Does Organization have Tax Exempt Status? Yes No 11. Web Address:

12. Event Organizer/Applicant Name: 13. Title:

14. Street Address:City/State/Zip:

15. Phone #:

16. Email Address: 17. Cell #:

18. Alternate Event Contact Name: 19. Phone #:

20. Email Address: 21. Cell #:

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22. Will Applicant attend this event and act as the on-site event supervisor? Yes No

NOTE: If Applicant is NOT the on-site supervisor for this event, please complete items #23-27.

23. On-Site Event Supervisor’s Name:

24. Street Address:City/State/Zip:

25. Phone #:

26. Email: 27. Cell #:

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28. Event Name:

29. Date(s) of Event: Start Date End Date Rain Date(s)

If Event/Activity is ongoing, list days of the week and date range:

30. Set up time: Event Start Time: Event End Time: Departure Time:

31. Event/Activities will take place: Indoors Outdoors Both

32. List Specific Areas of the site where Event/Activities will take place:

33. Event is Open to: Students Only School Community (Staff/Students/Families) General Public

34. # of Participants: # of Volunteers: # of Staff: Total Attendance:

35. Describe Type of Event and Activities Involved:

36. Is this a first time event at this location? Yes No If no, describe how this event differs from previous years:

37. Attendance Total for last event: 37. Event Website Address:

38. Will the Event involve Participants engaging in Athletic or Physical activities? Yes No If yes, describe:

39. Will there be any Amusements (Inflatable/Mechanical Rides) or Temporary Structures such as Stages, Tents,Booths/Tables, etc. installed for this event? Yes No

If yes, describe:

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40. List Event Vendors/Contractors/Businesses, contact e-mail addresses, and applicable Services below (i.e., Amusement Rentals, Equipment Rentals, Caterers/Restaurants, DJs, Entertainers, Program Instructors, Event Management Firms, etc.)PLEASE ATTACH ALL CONTRACTS. Note: See Required Documents Checklist at the end of this Application.

Vendor/Contractor Name & Contact Email: Type of Services:

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fo 41. Do you plan to sell, distribute, or give away refreshments/food as part of this event? Yes No

If yes, Selling or Giving Away42. Describe All Type(s) of Food (i.e., bake sale, prepackaged commercial products, catered, restaurant, carnival food-

popcorn/cotton candy/snow cones, potluck, fresh food prepared on site, other, etc.):

Note: Any event open to the General Public and having food prepared on site requires a Loudoun County Health Department certificate or a temporary food permit. See Required Documents Checklist at the end of this Application.

43. Are you requesting use of the school kitchen or concession facilities? Yes No

44. Will there be outdoor cooking or gas grills/propane stoves used (charcoal grills are prohibited)? Yes No

45. # of Food Vendors: 46. # of Food booths or tables set up:

47. Do you plan to sell, distribute, or give away merchandise (non-food items) or services in conjunction with this event? Yes No If yes, Selling or Giving Away # of booths/tables set up:

48. List types of Event Exhibitors and Retailers:

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49. Is this a Fund Raising Event? Yes No If yes, explain:

50. Will donations/contributions be accepted or solicited during this event? Yes No

51. If yes, explain how donations will be generated or solicited:

52. List all parties who will receive the proceeds from the donations/contributions:

53. Will a registration, membership, or admission fee be required in order to attend or participate in the event/ activities? Yes No If Yes, Name of Payee:

54. Will any payments or fees be collected on site? Yes No

55. If yes, what methods of payment will be accepted? Cash Check Credit Card

56. Will any payments or fees be collected on line? Yes No

57. If yes, give Name & Web Address of Online Payment Portal:

58. Name of Organization(s) making payments to Event Vendors:

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59. Are you requesting use of electricity? Yes No

60. Will generators be used as a power source? Yes No

61. Are you requesting access to a water source besides water fountains? Yes No

62. Are you installing any major decorations for this event? Yes No

63. Are you having live musical entertainment or a DJ for this event? Yes No

64. Do you plan to have animals on site during this event? Yes No If Yes, Explain:

65. Will any public street(s) need to be partially closed or blocked off in conjunction with this event? Yes No

If yes, street name(s):

LCPS Special Event Application 9/2/15 Page 3 of 4

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66. Will event involve use of non-school property, i.e. neighborhoods, sidewalks/trails, facilities, businesses, etc.? Yes No

If yes, describe:

67. Are you providing portable toilets for your event? Placement to be on hard surfaces only. Yes No How many: Where will they be set up:

68. Describe plans for providing emergency medical/services for your event (i.e., school clinic staff, call 911, on-siteemergency services, etc.):

69. Estimate # of parking spaces that will be used for your event:Note: All vehicles must be parked in designated parking spaces or they may be ticketed and/or towed.

70. Will shuttle services be used for off-site parking? Yes No

71. Describe plans for event trash/recycling collection and disposal:

72. Are there any special provisions or information pertaining to your event which have not been addressed on thisapplication/questionnaire? Yes NoIf yes, explain:

Checklist and Required Documents

Yes No N/A Date

Submitted Document Checklist—Attach the following documents to this Application

a. Event Flyer or Web page advertising event to Participants & Attendeesb. Map of School/Site marking Event Logistics-Set up, ingress/egress, areas used, etc.

c. Vendor Contracts for DJs, Entertainers, Games, Inflatable/Mechanical Amusements,Stages, Tents, etc.—County permits may be required—LCPS will assist with this process.

d. Food Vendor Contracts & Health Dept. Certificate or Temporary Food Permit-see moreinformation at this link: http://www.loudoun.gov/documentcenter/view/114

e. Fund Raising Events—Letter(s) of acknowledgement to or from the Organization(s) forwhich the Event will benefit

f. LCPS Facility Use Request Form for Non-School Users-Form must be Approved by a SchoolAdministrator (N/A for School Events)— Request form is at this link: Application forCommunity Use of School Facilities and Grounds by all Non-School Users

g. Event Sponsor’s Certificate of Liability Insurance (N/A for School Events)

h. Event Sponsor’s Documentation of Tax Exempt/Non Profit Status (N/A for SchoolOrganizations)

i. Race Events—Map of Race Course and Course Certification

j. Race Events—Event Planner/Race Consultant Contract outlining services to be provided

k. Race Events—Race Management Firm Contract (outlining services to be provided for racepromotion, registration, entry fees and donations, course set up, check-in, race timing, etc.)

l. Race Events—Copy of Event Participant Registration Form

m. Race Events—Permission letter from HOA or other property owners involved

n. Race Events, Parades, & Other Road Closures—Copy of VDOT Permit-Application found atthis link VDOT Road Closure Permit Application

o. Race Events, Parades, & Other Road Closures—Copy of Loudoun County Sheriff’s OfficeAgreement to Provide Law Enforcement/Security Services

p. School Graduation Ceremonies—Copy of completed Loudoun County Fire Marshal’s PermitApplication for School Assemblies—Link for Application Loudoun Co Fire Marshal-AssemblyPermit App

q. PTSA/PTSO Post Prom and All Night Graduation Events—Copy of completed LoudounCounty Fire Marshal’s Permit Application for School Assemblies—link for Loudoun CountyFire Marshal's Permit Information Packet & Sample Permit AppLink for Blank Application is Loudoun Co Fire Marshal-Assembly Permit App

r. ALL EVENTS open to the general public, involving a large number of attendees or requiringpublic safety or security—Complete the Loudoun County Special Event Registration at thislink http://interwapp01.loudoun.gov/repi/eventRequest.aspx

LCPS Special Event Application 9/2/15 Page 4 of 4

LCPS Special Event Application…continued

Event Applicant Comments or Questions: P

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PROCUREMENT SERVICES AND LCPS USE ONLY

Explanation:

Event status is pending the receipt of further information on the following:

Event may proceed under the following conditions/restrictions:

Reviewed by Name & Title: Date:

Email: Phone #:

Copies to: School Principal School Event Contact

Safety & Security Other: ________________________

Event Registered with Loudoun Co OEM? Yes No N/A

Permit(s) Necessary? Yes No List:

Event Logged on LCPS Special Event Spreadsheet? No

Permit(s) Received from Loudoun Co?

Permit(s) Sent to School? Yes No N/A

Notes/Comments

Support Services

Facilities Services

Appropriate Director of Education

Yes

Yes No

Event Documents are: Complete Incomplete

N/A

Loudoun Co. OEM

Event Location at LCPS Facility:

Event Name:

Off-Site Event Location:

Sponsoring Organization:

Date:Date:

Event Contact Name:

Event Dates: Start _______ End _______ Rain _______

Event Times: Set Up ________ Departure ________

Contact Email: