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Photography, Filming or Video Taping Permit Form

  1. Production Information *
  2. Event Information
  3. Site*
  4. This is the site, address or nearest intersection you will be working.
  5. If more than one date complete the items below:
  6. Site
  7. This is the site, address or nearest intersection you will be working.
  8. Site
  9. This is the site, address or nearest intersection you will be working.
  10. Will you be requesting reserved parking areas on public streets?*
  11. Will you be requesting road closures?*
  12. Will you be requesting assistance from our Public Safety Dept. (police or fire)?*
  13. Describe purpose of event and what we should expect on the dates of the event.
  14. Example: police or fire personnel, public sidewalk or road closures, special needs for event.
  15. The applicant acknowledges the following*
    The applicant agrees to reimburse the City of East Grand Rapids for the cost of any services provided by the city as a result of the event. The applicant agrees to obtain and maintain a certificate of liability insurance demonstrating approved coverage throughout the event and naming the City of East Grand Rapids and East Grand Rapids Public School District as an additional insured. A copy of the insurance certificate must be provided no less than 48 hours prior to the event. Applicant hereby releases the City of East Grand Rapids, its officers, agents, and employees from all liability and waives any and all rights and claims for any and all injuries or damage to person or property, possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19 and accidents which may occur as a result of the use of City facilities. While particular rules and personal discipline may reduce this risk, the risk of injury, serious illness and death does exist. In addition, applicant agrees to indemnify the city, its officers, agents, and employees from and against any and all claims, judgments, losses, damages, demands, and legal proceedings arising out of or resulting from the use of City facilities. I understand that all information submitted to the City of East Grand Rapids is considered public information and subject to disclosure under the Freedom of Information Act.
  16. Leave This Blank:

  17. This field is not part of the form submission.