Carnivals and Cruises License Application

License Application for - Carnivals and Circuses

MUNICIPAL CODE SECTION – 4-22
South Bend Municipal Code: Section 4-22

Definition:
1. Carnival. The term "carnival" as used herein shall mean and include amusement activities, rides, merry-go-rounds, booths for the conduct of games of skill, food dispensing facilities and sideshows presented by traveling companies.
2. Circus. The term "circus" as used herein shall mean and include performances given by traveling companies on vacant lots with tents, or some other kind of temporary enclosure, where performances are given for a fee. Performances may include, but are not limited to: Trained animal acts, races, feats of horsemenship, acrobatics, strength, trapeze acting, or clowns.
General Instructions and Application Process:
1. Assemble all required information and materials before filing application.
2. Thoroughly review all applicable Municipal Code Sections listed above.
3. Licenses expire January 31.
4. Add 10% to license fee for renewal after expiration.
5. Include $5.00 license application fee payable to City of South Bend.
6. License fee payable to City of South Bend due at issuance - $105.00.
Required Information and Materials:
1. A site plan, drawing, or diagram of the carnival
2. Proof of liability insurance with the City of South Bend listed as an additional Certificate Holder.
Questions?

For all municipal business license questions, contact:

City of South Bend

Department of Community Investment

215 S. Dr. Martin Luther King Jr. Blvd.

Suite 500
South Bend, Indiana 46601

Email: BusinessLicense@southbendin.gov

Phone: 574.235.5912

Fax: 574.235.9021

Application Type
Is this application pertaining to a new business or are you renewing your existing permit?

New PermitRenew Permit
Business Data
Name of Traveling Company*
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does Mailing address differ from Property Address?*

Yes, different addressNo, Same address
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Business Email Address*
example@example.com
Zoning of Business Location*
Use the South Bend Zoning Map to find your business's Zoning Type.
What is the location of proposed carnival or circus? Give as precise a description as possible.*
Proposed Start Date of Carnival or Circus*

MonthDayYear
Proposed End Date of Carnival or Circus*

MonthDayYear
Number of Sideshows to be included*
Number of Food Vendors to be included*
Date issued and number for other licenses issued by the City for any vendor associated with the Circus or Carnival*
Insurance Information
Insurance Carrier*
Insurance Agency*
Amount of Liability Insurance*
Upload Liability Insurance with The City Of South Bend listed as an additional certificate holder.*

Cancelof
Is the applicant a not-for-profit corporation?*

YesNo
Provide proof of non-for-profit status*

Cancelof
What is the purpose of the not-for-profit corporation?*
Personal Data
Applicant's Legal Name*

First NameMiddle NameLast Name
Applicant's Residential Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applicant's Home Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Applicant's Cell Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Applicant's Email*
example@example.com
Last Four Digits of Applicant's Social Security Number*
Copy of Applicant's Driver's License or other Government-Issued ID

Cancelof
Gender*
Race*
Applicant's Position with Organization*
Date of Birth*

MonthDayYear
Signature
I, hereby, certify and affirm that all of the information I have given in this application is true and accurate to the best of my knowledge. I further certify and affirm that I have in no way attempted to mislead the city in this application by omitting facts known to me. I agree to permit periodic inspection of my equipment by the Board of park Commissioners or their agent. I have read and understand the regulations of Carnivals and Circuses license found in the City of South Bend Municipal Code, Section 4-22.
Electronic Signature*

First NameLast Name
Date*

MonthDayYear
Should be Empty:

License Application for - Carnivals and Circuses

Definition:

General Instructions and Application Process:

Required Information and Materials:

Questions?

Application Type

Business Data

Insurance Information

Personal Data

Signature