Jerome, AZ · Yavapai County
Special Event Hold Harmless and Indemnification Agreement
This agreement is for a company or other permittee seeking a Jerome special event permit and sets out responsibilities related to event claims and insurance.
What this form is
A permittee signs this agreement in consideration for the issuance of a Special Event Permit. It sets out the permittee’s obligations to indemnify, defend, and hold harmless the Town of Jerome and related people from claims connected to the event, and addresses communicable disease risks and insurance. The agreement asks for the event description, signature, printed name, witness signature, and witness printed name.
Who needs it
A company or other permittee seeking a Jerome Special Event Permit needs to sign this agreement and provide the event description.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This agreement is signed without a notary; it lists signature and witness fields, with no notarized attachment or sworn step stated.
How to submit this form
- 1
Download The Agreement
Download the Special Event Hold Harmless and Indemnification Agreement PDF.
- 2
Complete The Agreement
Add the company or permittee name and a description of the special event, then complete the signature and printed-name fields.
- 3
Gather Related Information
Review the special event application for insurance requirements; the agreement states that the application is incorporated into it.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What is the Special Event Hold Harmless and Indemnification Agreement?
- It is an agreement a permittee signs in consideration for a Jerome Special Event Permit, setting out obligations related to claims, event risks, and insurance.
- Do I need a notary for the Special Event Agreement?
- No. The agreement lists signature and witness fields and does not include a notary block or state a notarized attachment or sworn step.
- How do I submit the Special Event Agreement?
- The document does not give submission instructions. Submit it to the city department named on the form; check the city website for current contact details.
- What information and signatures does the agreement ask for?
- It has a space for the event description and asks for the permittee’s signature and printed name, plus a witness signature and printed name.
