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2. Musician/Band Name:*
4. Primary Contact:*
6. Street Address:*
8. City:*
9. State:*
10. Zip Code:*
12. Phone Number:*
13. Mobile Phone:*
15. Email Address:*
17. Website or Social Media Link:
18. What is your preferred method of communication?*

    1. E-mail
    2. Phone
20. Please list names of employees, partners or family members who will be performing with you.*
22. Band type/genre:*
23. Tell us about your your band:*

    Please write a short biography/story (5 sentences), such as your mission, genre, history, etc. that we can place on the website/Facebook to promote your business.

25. Please provide us with any links we can review of your group performing:
27. Friday at the Flats Event Dates (Fourth Friday). Please check the dates your group is available (check all that apply):*

    1. May 24 (Craft Market)
    2. June 28

    1. July 26
    2. August 23
29. Availability: Please check all options you are available for (Please note picking a date/time does not guarantee that time or date):*

    1. May 4:30 PM
    2. May 6:45 PM
    3. June 4:30 PM
    4. June 6:45 PM
    5. July 4:30 PM
    6. July 6:45 PM
    7. August 4:30 PM
    8. August 6:45 PM
31. Time Slots/Time Frame:

    4:30 PM slot - 4:30 PM start – arrival no later than 3:30 PM

    6:45 PM slot - 6:45 PM start – arrival no later than 5:30 PM

    3:00 PM - Park Staff Setup
    3:30 PM - Provided equipment setup
    4:30 PM -  Event opens
    4:30 PM - 5:15 PM Set 1 – Group 1
    5:30 - 6:15 PM Set 2 – Group 1
    6:15 - 6:45 PM Sound check/changeover of groups
    6:45 - 7:30 PM Set 1 – Group 2
    7:45 - 8:30 PM Set 2 – Group 2 
    8:30 PM - Event closes

33. What the City Provides:

    Basic Small Event Sound Setup: 
    Speakers
    Mixer (6-8 channels)
    Two Microphones (Feel free to bring your own if you prefer)
    Two Stands 

    You are more than welcome to bring additional equipment you need for your group, however this must be cleared with the event manager and sound technician two weeks prior to the event. As a group/single you are responsible for any cords to connect your equipment to the standard sound system. If you have any questions on what you need/what is provided, please reach out two weeks prior to event week.

35. Event Summary

    We are bringing the taste of Portage to you! Friday at the Flats returns to the Celery Flats Pavilion in 2024. Join us on the fourth Friday of the month for dinner and experience a wide range of food vendors and live music. Seating is limited, but lawn space is plentiful, so bring a blanket or chair. Connect with your loved ones at Celery Flats through food and fun. While at the event, join the Friday at the Flats Community Food Drive! All items must be sealed, undamaged, unexpired, non-perishable or canned food. Some examples of current needs are: jelly/jam, cereal, canned soups, boxed meals (e.g. Hamburger Helper), shelf-stable powdered milk, baking mixes (e.g. Jiffy or Bisquick), shelf-stable tortillas, granola bars or microwavable foods (like rice in a bag). Donations can be dropped off at the donation bin at the Portage Parks & Recreation tent throughout the event.  
     
    » Celery Flats Pavilion (7335 Garden Lane)
    » FREE Admission

37. Payment and Forms:

    Payment is $200 per slot and the liability waiver signed in this application applies to the band and all those that assist the band.

    Not all groups that reach out are guaranteed a spot regardless of new or returning status due to the limited number of spots versus interest in the events.

39. Select each line item to which you agree; leave blank those to which you do not agree or (not applicable to your group):*

    1. I have read and understand the time slots/time frame schedule and that my actual date/time will be later assigned via the Event Manager.
    2. I have read and understand what the City provides for setup and any changes must be communicated two weeks prior to performance.
    3. I have read the event summary.
    4. I have read and understand payment and agree to complete all forms required.
    5. I understand not all groups that apply are guaranteed a spot regardless of new or returning status due to the limited number of spots versus interest in the events.
43. Release of Liability

    I, the undersigned, release, discharge, waive and hold harmless the City of Portage, its officers, agents, representatives and employees, from and against any and all liability, actions, causes of actions, claims known or unknown now existing or that may arise in the future arising out of or connected in any way from participation in the activity, even though liability may arise out of negligence or carelessness on the part of other persons or entities. I also hereby for myself or any participant for who I am responsible, waive, release and discharge any and all claims for damages for death, personal injury or property damage which may subsequently accrue as a result of participation in the activity. I acknowledge, that the City of Portage, including the City of Portage Parks & Recreation Department are not to be held responsible for damaged or lost items brought to this activity. 

    I further understand and acknowledge that accidents may occur during an event or activity which may result in personal injuries and/or property damage as a consequence thereof. Knowing the risks involved, I nevertheless, agree to assume those risks and to release and hold harmless all of those persons and entities mentioned above who, through negligence or carelessness, might otherwise be liable to me, or my heirs or assigns, for damages. 

    It is further understood and agreed that this waiver of release is an assumption of risk and is to be binding on my heirs and assigns. 

    I agree to be fully responsible for any injury or damage to any non-participant who may accompany me and hold the City, its officers, agents, representatives and employees harmless from any liability or actions which may result. 

    I further agree to abide by and accept all of the rules conditions and regulations of the City of Portage which are a condition of my participation in this Project. 

     I understand and my band understand I am the individual representing and releasing liability and agreeing to this application for everyone. 

    I understand I will need to provide a W-9 to be paid out by the City.

    I understand funds are paid at the end of my agreed upon time with completion of musical event.

    I understand what equipment the City of Portage provides and if I/we want to bring our own or supplemental information, we will inform the event manager two weeks prior to the event or earlier.  

    I understand it is my responsible to start on time and allow enough time for setup and keep our equipment minimal to allow the changeover to be 15 mins of tear down maximum.

45. I have read and agree to the Release of Liability*

    1. Yes
    2. No
49. Publicity Release

    The City of Portage has my permission to use my or my child’s photo/image, voice or an item created by myself or my child including photos, drawings/illustrations, sculptures or other submitted item for promotional or educational purposes only including exhibition displays.  The City of Portage will receive the right to reproduce, at its own expense, images including, but limited to printed materials, online publications, news releases, videos, advertisements, media sites, website and social media outlets. I also provide permission for my name to be used in conjunction with the photos, videos or exhibition items for display, however in the case of a child under 18 years of age, only the first name and last initial will be used.  I also understand that no royalty, fee or other compensation shall become payable to me, or my child, by reason of such use.  I hereby release the City of Portage and its agents and assigns from any and any claims which may arise out of or are in any way connected with such use. If signing this Publicity Release form on behalf of a child (under 18 years of age), I certify that I am the parent or guardian of that child listed below. 

51. *The City will not release or publicize your address, phone or email. The information provided will be used for internal purposes only to contact you in regards to the publicity release.
53. I have read and agree to the Publicity Release*

    1. Yes
    2. No
57. Electronic Signature Agreement:

    By signing below, you certify that the information provided on this application is true and accurate and pledge that, as a musican of the Portage Friday at the Flats, you will abide by the 2023 Portage Rules and Guidelines.

    1. I agree.
59. Electronic Vendor Signature:*
60. Date:*
    Date:
62. Electronic Vendor Signature Agreement:*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. 

    1. I agree.
66. For Portage Parks and Recreation Staff ONLY
68. Event Manager Signature
69. Date:
    Date:
71. Parks Director Signature
72. Date:
    Date:
Leave This Blank:


74. 1. Receive an email copy of this form.
75. Email address

    This field is not part of the form submission.

76. Submit Submit and Print

* indicates a required field