Fillable Form 11810 Street Performer Application (Town of Fort Myers Beach)

Fill Online, Printable, Fillable, Blank Form 11810 Street Performer Application (Town of Fort Myers Beach) Form

Use Fill to complete blank online TOWN OF FORT MYERS BEACH (FL) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Form 11810 Street Performer Application (Town of Fort Myers Beach)

On average this form takes 11 minutes to complete

The Form 11810 Street Performer Application (Town of Fort Myers Beach) form is 16 pages long and contains:

  • 0 signatures
  • 18 check-boxes
  • 34 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Town of Fort Myers Beach

BROWSE TOWN OF FORT MYERS BEACH (FL) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Town of Fort Myers Beach
2525 Estero Blvd Fort Myers Beach, Florida 33931
Phone: 239-765-0202 Fax: 239-765-0909
STREET PERFORMER APPLICATION
3/22/16
\\FMB-DC1\Folders 2\Community Development\Administrative Documents\Applications, Permits, Forms, etc\Updated Permit Applications WORD\Street
Performer Application.docx
Official Use Only:
Permit #STP
Name:
Email:
Address:
Phone: Cell Phone:
Application Information
1. Are you over the age of 16? Yes No (If no, please complete the attached Parental Consent Form)
2. Describe, in detail, your performance including any costumes or materials used in your act. (Attach separate sheet if
necessary)
Please select one: Individual Performer Performer within a group
Please select the type of performance:
Dance Artist Mime/Statue
Juggling (non-dangerous implements) Musician (specify instrument(s)
Other (Please specify the type of performance and supplies/equipment used. Attach separate sheet if necessary)
3. Have you previously held a Street Performer Permit with the Town of Fort Myers Beach? Yes No
If yes, please specify when:
Proof of Identity
You must provide proof of your identity and proof of identity of your parent/guardian if you are under the age of
18. Please check the item(s) below which you will provide as proof of identity.
Performer Guardian
Driver’s License/State ID card
School ID card
Other, please list: ____________________
Driver’s License Number
(Performer) Driver’s License Number (Parent/Guardian)
State: State:
Town of Fort Myers Beach
2525 Estero Blvd Fort Myers Beach, Florida 33931
Phone: 239-765-0202 Fax: 239-765-0909
STREET PERFORMER APPLICATION
3/22/16
\\FMB-DC1\Folders 2\Community Development\Administrative Documents\Applications, Permits, Forms, etc\Updated Permit Applications WORD\Street
Performer Application.docx
Official Use Only:
Permit #STP
You must submit the completed application including the background check form and parent/guardian
consent form (if applicable) at Town Hall. A Town employee will schedule an appointment time to
discuss your application. A photo will be taken at the time you complete your interview. **This photo
does not guarantee that your permit application will be approved.** If the background check is
approved and the Street Performer requirements are met, a permit will be issued.
As a condition of issuance of the Street Performer Permit, the applicant agrees to indemnify, defend
and hold harmless the Town of Fort Myers Beach and its officers, employees and agents from any suit,
actions or claims arising out of, or in any way connected to, the activities permitted pursuant to this
Article, except for any claims or liability arising solely from the negligence or misconduct of the Town,
its officers, employees or agents.
I have read the attached rules and regulations for performers as outlined in the Town of Fort Myers
Beach Ordinance 15-09 and agree to the terms and conditions set forth. Further, I authorize the Town
of Fort Myers Beach to conduct a criminal background investigation.
Signature
Typed or printed name Date
Town of Fort Myers Beach
2525 Estero Blvd Fort Myers Beach, Florida 33931
Phone: 239-765-0202 Fax: 239-765-0909
STREET PERFORMER APPLICATION
3/22/16
\\FMB-DC1\Folders 2\Community Development\Administrative Documents\Applications, Permits, Forms, etc\Updated Permit Applications WORD\Street
Performer Application.docx
Official Use Only:
Permit #STP
PARENT / GUARDIAN CONSENT FORM
I, (print name)
residing at (address)
hereby give my consent for my child/ward:
Minor Name: Age:
To apply with the Town of Fort Myers Beach as part of the Street Performer program and abide by all
regulations therein.
I understand that the Town of Fort Myers Beach provides no supervision and that I must accompany
my child/ward at all times.
Parent/Guardian Signature:
Parent/Guardian Name: Date:
Relationship to Minor:
Identification of Parent/Guardian: Driver’s License State ID Passport Other
Document Number:
OLD SAN CARLOS BLVD
FIRST ST
F
O
U
R
T
H
SECOND ST
SAN CARLOS BLVD
F
I
F
T
H
CRESCENT ST
THIRD ST
THIRD ST
E
S
T
E
R
O
¯
Town of Fort Myers Beach, Florida
DEPARTMENT OF PUBLIC WORKS
2523 ESTERO BOULEVARD, FORT MYERS BEACH, FLORIDA 33931
(239( 765-0202
Date: Drawn By: Sheet: Scale:
9/29/2015 PW GIS
1 " = 100 '
\\GIS-SRV\GIS_Data\ArcGIS Map Docs And Reports\FM B-C omm Dev\StreetPerformerLocationMa p_201509.mxd
Exhibit A - Street Performer Location Map
1
Old San Carlos ROW Area
Time Square ROW Area
Bayside Park Area
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Form 11810 Street Performer Application (Town of Fort Myers Beach)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 18 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document