Lansing, MI

Application for Show License

Contact us
If you desire assistance or have questions about this form, you can email us at [email protected], call us at (517) 483-4133, or visit us in the City Clerk's office, located on the 9th floor of City Hall (124 W Michigan Avenue, Lansing, MI 48933).
Show License Application
The undersigned hereby applies for a license to sponsor, operate, exhibit, perform or cause to be operated, exhibited or performed a "show" within the limits of the City of Lansing, Michigan. Show means any circus, menagerie or other exhibition, entertainment, carnival or show, of any nature and name for which money or any other consideration is in any way demanded or received for admission.
Instructions
Fill out and print this form. Bring this form and the materials listed to the City Clerk's office to complete the application process.
Materials
Fee: $250.00 per day/per location, not to exceed $1000.00 per year/per location. Site plan and security plan may be required. This form may be notarized at the City Clerk's office.
Full Name of Applicant*
Applicant's Street Address*
City*
State*
Zip code*
Applicant's Phone Number*
Applicant's Email Address
Applicant's Date of Birth*
Applicant's Date of Birth
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Insured By*
for Public Liability in the amount of $300,000 to $500,000 and Property Damage in the amount of $100,000. The City of Lansing must appear as an additional insured and receive a 10-day cancellation notice.
Policy Number*
Date Issued*
Date Issued
Expiration Date*
Expiration Date
Bonded By*
in the Penal Sum of $1,000.
Bond Number*
Date Issued*
Date Issued
Expiration Date*
Expiration Date
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I understand that a false statement on this application may result in either a denial of this application or subsequent revocation if this license is granted.
Check one*
1. Yes
2. No
Has the applicant, owner, or sponsor; or any person with an ownership interest in the applicant, owner, or sponsor; or any person who will manage the show had any citation or conviction for, or guilty plea to, a violation of the laws of the United States, any State or any local unit of government regulating the operation of a show?
If yes, disclose details:
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Applicant's Signature (DO NOT sign except in the presence of a notary)
___________________________________________________________________
Date
________________
Subscribed and sworn to before me this ________ day of ____________________, 20_______, acting in the County of ____________________, Michigan.
Notary Signature
___________________________________________________________________
Date
________________
Print Notary's Name
___________________________________________________________________
Commission Expires
________________
Approved by Building Safety Division
Date
Date
Approved by Fire Marshal
Date
Date
Approved by Chief of Police
Date
Date
Amount paid
Date paid
Date paid
License number

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