Young Marines (YM)

Date of Request*

Regiment/Unit*

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Contact Person*

First Last

Email*

Enter Email Confirm Email

Daytime Phone Number

Fax Number

Describe Event*

(Training/Drills, Meeting/Seminar, Encampment, Picnic, etc.)

Are you the sponsor?

Yes
No

If NO, name of main sponsor

First Last

Date(s) of Event*

Address of Event*

Estimated attendance*

Number of Exhibitors*

Admission to be charged

Expected gross receipts

Will event be held indoors or outdoors?*

Indoors
Outdoors

Have you conducted similar events in the past?*

Yes
No

If YES, has there been any claims/losses?

Yes
No

If YES, describe past claims/losses

Describe security to be provided*

Describe first aid to be provided*

Will there be amusement rides or fireworks?*

Yes
No

Describe refreshments planned*

Are refreshments complimentary or purchased?*

Complimentary
Purchased
Not Applicable

How will refreshments be provided (caterer)?*

Describe any cooking to be done*

Does another party need a Certificate of Insurance other than what you already have?*

Yes
No

Name

First Last

Attention

Address

Street Address Address Line 2 City State ZIP Code

Phone Number

Fax Number

Does the other party require "ADDITIONAL INSURED" wording?

Yes
No

If YES, describe their interest

(landlord, owner of premises, lessor, event sponsor, etc.)

Have you agreed to "HOLD HARMLESS" the other party?

If YES, please forward a copy of your contract, permit, or agreement.

Yes
No

If a contract, permit or agreement has been signed, please attach a copy for review.

Max. file size: 128 MB.

By clicking the "I Accept" checkbox, you are signing this Questionnaire electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Questionnaire.*

I Accept

Comments

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Young Marines (YM)

Special Event Questionnaire