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THE SCHOOL DISTRICT OF PALM BEACH COUNTYRISK AND BENEFITS MANAGEMENTRisk Planning ToolSpecial Events, School Activities, Field Trips, & LeasingSELECT ONE CATEGORY:SPECIAL EVENTLEASEComplete at a minimum of 15 days prior to the event being held on Schoold District CampusThis tool is designed to assist you in being risk informed when planning your Special Event or Leasing your facility. Please be awarethat the school sponsoring the special event/lease is the Risk Owner - this planning tool incorporates procedures and policy items tocreate strategic decisions for a safe leasing experience. This planning tool is designed to be used in coordination with the most recentcopy of the Special Event Risk Planning Guide (SERPG) along with the policies and directives set by the School Board of Palm BeachCounty and each department.Applicable School Board Polices:Policy 2.16Policy 2.40Policy 2.54Policy 6.28Policy 7.18Policy 7.24Risk & Benefits Management:Special Event Risk Planning Guide (SERPG) - obtain from Risk ManagementBurn Permit InformationWebsite Address or Facebook Page (if applicable to event/company/vendor)Name of School or FacilitySelect OneSPECIAL EVENTS CONTACT INFORMATION - Special events, school activities or field tripsSpecial Events Audience: After School Program Directors, Club Sponsors/Boosted Clubs, Department Heads & Directors,Project Graduation Coordinators, Regional Offices, School After Care Directors, School Based Admin, Summer Camp Directors.Sponsor (see Info button if PTA/PTSA/PTO)Contact Name of Person Completing ToolTitlePhone#Email AddressContact Name of Person Vendor #1TitlePhone#Email AddressContact Name of Person Vendor #2TitlePhone#Email AddressContact Name of Person Vendor #3TitlePhone#Email Address* Attach additional vendor information using the "Attach PDF" button on page 6LEASING CONTACT INFORMATION - Type of ApplicantIndividualFor Profit EntityNot for Profit EntityLeasing Audience: Directors, Lessees, Leasing Coordinators, Principals, PTA/PTSA/PTO, Regional OfficesName of Lessee (PTA/PTSA/PTO, Booster Club, For Profit Educational Services provider, etc.)Contact Name of Person Completing ToolTitlePhone#Email AddressContact Name of Person Leasing FacilityTitlePhone#Email AddressPBSD 2498 (Rev. 11/1/2019)ORIGINAL - SchoolPage 1 of 6

Risk Planning Tool, cont.1. DESCRIPTION OF EVENT:Date of EventLength of EventHours: StartYesWill this be open to the public?Hours: FinishNoWill there be participants on site during the night (after midnight or before 6:00am)Is this a recurring event?YesMaximum Daily Attendance Total Daily AttendanceYesNoNo If yes, how often?Attach a copy if there is a flyer or brochure. Event disclaimer MUST be printed on it.2. Have you reviewed Board Policy 7.18 and the lease terms and conditions?Yes3. Have you reviewed the latest version of the Risk Planning Guide?YesNoNoWhat type of Activities are Planned?Green Light Activities?YesNo Describe:Yellow Light Activities?YesNo Describe:PTA/PTSA/PTO EVENTS ONLY:Will the activity require the participant to sign waiver of liability agreement (under 18) PBSD 2448?As per SERPGYesNoN/AWill the activity require the participant to sign waiver of liability agreement (over18) PBSD 2449?As per SERPGYesNoN/A4. WILL THERE BE ATHLETIC OR HIGHER RISK ACTIVITIES? (Examples: soccer tournaments or practice, swim andgymnastics meets, tennis tournaments, and dance/cheer competitions, karate, dance recitals, Zumba and any other activity thatmeets the definition of an athletic activity)If yes, is there Participant Insurance Coverage with a minimum of 25,000 in coverage? If yes, attach a copy ofthe certificate of insurance.Estimated age group of the participants: From:Will the event be run through Internal Accounts?5. APPLICANT AN EVENT PLANNER?YesYesNoYesNoTo:YesNoNoWill the Consultant Agreement be used? The activity operators must hold the School Board harmless(PBSD 2496) if event is on District Property. Attach with this applicationYesNoHave the Activity Operators been "badged" (attach copy) and cleared to be on District property?YesNoN/AIf needed, per the SERPG, does the applicant have certificates of insurance from the vendor(s)?Attach with this application.YesNoN/AActivities/rides that need to be inspected by a certified operator/inspector area red light activity. This is not allowed by the District.I understand this. Please initialNOTE: Pursuant to SB Rule 2.16, due to the inherent dangers posed by mechanical rides, no one is permitted to allow anymechanical rides on School District property or any school sponsored activity for any activities whatsoever.PBSD 2498 (Rev. 11/1/2019)ORIGINAL - SchoolPage 2 of 6

Risk Planning Tool, cont.6. ENTERTAINMENT:Will live entertainment be provided?YesNo If yes, describe:If a concert, type of music, i.e. gospel, classical, rock:Any special effects for the concert? Reminder, pyrotechnics are a red light activity.Any student entertainer interaction/participation?YesNo If yes, explain:Is the entertainment "badged" to be on the property?YesNoN/AWill there be a movie shown? It must be consistent with the educational mission and vision ofThe School District of Palm Beach County. Refer to Policy 7.18.YesNoN/AIf yes, what is the movie title and rating. Provide description:7. RUNNING/WALKING/BICYCLE EVENT:YesNoIs the route free of hazards and clearly marked?YesNoN/AWill all pedestrians and vehicular traffic be separated and rerouted?YesNoN/AWill "color powder/paint" be part of the event?YesNoN/ANOTE: If yes, you must reach out to Risk and Benefits Management to review the materials being used. Prohibited materialsare not allowed. (Reminder: Color Runs are a red light activity)8. FILMING: Will there be professional filming?YesNoHas the single source - WAIVERS AND "RIGHTS OF CONTENT" (PBSD 1941) been signed? Policy 2.549. FOOD SERVICE PROVIDED: Policy 7.18YesYesNoN/ANoWhat types of food and or drinks are being served at the event?Food allergy concerns? Warnings posted?YesNoN/AWill School Food Service personnel be serving food at the event?YesNoN/AWill food trucks be at the event? If yes, attach all the required documentsYesNoN/AReference and comply with requirements found in the SERPG Appendix H10. ANIMALS OR REPTILES: (Event shall be in compliance with School Board Policy 7.24 Animals on District Property)Will there be animals or reptiles at the events?YesNoNOTE: Lessees are not permitted to bring animals on School District property, only exception PTA/PTSA/PTO.PBSD 2498 (Rev. 11/1/2019)ORIGINAL - SchoolPage 3 of 6

Risk Planning Tool, cont.11. TRAFFIC CONTROL:Is traffic control needed?YesNoWill they have a safety vest available and/or be dressed in bright colors?Are parking areas properly designated?Will there be adequate parking?YesYesYesNoNoNoWhat are the alternate parking plans if needed?Has security been coordinated with school police if needed?YesNoN/A12. FIRST AID: (Example PTA/PTSA/PTO Events)Will first aid be available for the event?YesNoWill the schools AED(s) be available for the event participants?YesNoWill first aid/CPR certified District staff be on site in the event of AED operations?YesNo13. HOLD HARMLESS AND INSURANCE REQUIREMENTS - SPECIAL EVENTS:Does the applicant name on liability insurance match the applicant?YesNoN/ADoes the insurance meet the minimum School District of Palm Beach County requirements?If yes, attach certificateYesNoN/AWill any and all sponsor/vendors agree to hold the District harmelss? (PBSD 2496)YesNoN/ANOTE: The School Board of Palm Beach County shall be listed as additional insured on all general liability certificates of insurance.13. HOLD HARMLESS AND INSURANCE REQUIREMENTS - LEASE:Does the lessee have liability insurance in the same name as the applicant entity?YesNoN/ADoes the insurance meet the minimum School District of Palm Beach County requirements?If yes, attach certificateYesNoN/AWill the lessee hold The School District of Palm Beach County harmless? (PBSD 2496) PTA, PTSA, PTOYesNoN/AWill any and all additional sponsor/vendors agree to hold the District harmelss? (PBSD 2496) PTA, PTSA, PTOYesNoN/AWill any vendors be providing staff for operation and supervision of equipment?YesNoN/AIf yes, did vendor provide proof of workers' compensation insurance coverage certificate in the amountof Florida statutory coverage requirements? (SERPG Appendix G)YesNoWill the lessee/vendor be bringing motorized vehicles (box trucks, bus, tractor trailers) on campus to load/unload?YesNoIf yes, did vendor provide sponsor with proof of minimum School District of Palm Beach Countyrequired automobile insurance coverage? (SERPG Appendix G)YesNoWill lessee/vendor be bringing golf carts for use?YesNoNOTE: If yes, they must provide proof of insurance for golf carts. Lessees/vendors are not permitted to use District Golf Carts.Yes14. PROJECT GRADUATION, PROMS AND DANCES:Are students allowed to leave and return?YesNoNoN/AWhat events are being planned for this event?Yellow Light:Green Light:PBSD 2498 (Rev. 11/1/2019)ORIGINAL - SchoolPage 4 of 6

Risk Planning Tool, cont.Yes15. HOMECOMING:NoYesA. Will golf carts be used?B. Parade Floats?YesNo NOTE: Golf cart certificate training required. District personnel and certified volunteers only.NoHow is it being built?Who is driving?Auto Insurance?YesNo Name of Company?YesWill float have secure spots for students/faculty to sit or stand?YesC. Alumni flag football game?D. Bonfire?YesNoNo Reminder: PBSD 2449 Participant waiver must be signed.NoHas the municipality, city or county been contacted for a burn permit?YesNoDesired location of the burn?School Police involved?YesNoAdequate firefighting staff and equipment?YesFire extinguishers?NoYesNoHow many?What fuel will be used?REMINDER: School Police and Risk Management MUST BE CONTACTED if a bonfire is being considered for an event.I have read Burn Permit Information on Page 1. Please initial16. Is the School District of Palm Beach County site being leased for a funeral/wake/repass/memorial service?YesNoNotes: Funerals or other services where human remains are present (including caskets and urns) are prohibited. Only Memorial Servicespermitted by policy may be conducted after advance approval of the Regional Superintendent, Police Chief and COO.School Sponsored Memorial Services - Who is the service for? (select one):Student who was enrolled during current school yearEmployee who was employed at the school during the current school yearEmployee recently retired Year Retired:The individual being memorialized had a significant affiliation with the school community, as determined by the DeputySuperintendent/Chief of Schools or Superintendent. Please explain:(If this option is selected, it needs previous approval from DSCOS/Supt. Attach additional pages to explain if necessary)Memorial Services that are accessory to a regularly occurring Lease:What is the regular lease and how often is the facility leased?Will the lease take place while students are present?YesNoCROWD MANAGEMENT:17. Number of Police Officers to be present at the event:Will staff trained in Crowd Management be present at the event?PBSD 2498 (Rev. 11/1/2019)YesORIGINAL - SchoolNoIf yes, how many?Page 5 of 6