UNG Police Event Request Form

The UNG Police Department may provide fee-based security to organizations and events on an as-needed/as-available basis. This request can be made by and University organization or department.

Contact Name Contact Name * First Last
Please enter the first and last name of the contact person for the event.
Contact Phone Number Contact Phone Number * - ### - ### ####

Please enter phone number of event contact person.
Contact Email

Please enter email address we should use to reply to the event contact person.
Name of Event *
Maximum of 25 characters allowed. Currently Entered: 0 characters.
Enter the official name of the event.
Type of Event *

Identify the type of event being requested. (i.e. fundraiser, reunion, wedding, etc.)
Which campus is the event to be held on? *
Expected Number of Participants *

A number of expected participants must be entered.
Event Date Event Date * / MM / DD YYYY

Enter the date the event is scheduled to occur.
Event Date Event Date / MM / DD YYYY

Enter additional date if event is scheduled for more than date entered above.
Reporting Time Reporting Time * : HH MM AM/PM

Enter time officers are needed to arrive (to coordinate with event contact and position for event).
Ending Time Ending Time * : HH MM AM/PM

Enter the time the event is expected to end.
Organization or Department Name *

Enter the name of the organization or department requesting/hosting the event.
Description of Duties and/or Instructions for Officers *
Maximum of 350 characters allowed. Currently Entered: 0 characters.
Provide the expected duties and instructions for the officer(s) working the event. Provide any additional information that may be needed.
Disclaimer and Release of Liability

(Please Read Carefully) It is requested that the University of North Georgia Police Department, a division of the Department of Public Safety, supply officers for special security for the event listed below. It is understood that the work to be done must be coordinated through the Chief of Police or his designee. Appropriate arrangements will be made through this office to insure that each officer is properly equipped and informed of his/her duties and responsibilities as related to the event. It is understood that the officer(s) working the event are employees of the Police Department and remain under their supervision and control. Any questions should be directed to Deputy Chief Poole at 706-864-1500.

It will be understood that UNG Police Officers will not participate in determining if someone is under the influence or has consumed alcoholic beverages at the direction of the requesting organization or person. The officer(s) will not check identification for the purposes of determining if someone is of age to drink alcohol. This action will only be performed at the discretion of the officer while adhering to the policies and procedures set forth by the UNG Police Department in the officer’s normal duties. Compensation for each officer will be paid by the sponsor of the event at the rate of $42.00 per officer per hour. If the event is less than 3 hours, there will be a minimum fee of $100 per officer.

After the event, actual hours to be compensated will be confirmed by the UNG Police Department and the officer/s will be compensated by the requester. If the requester originates from a department or unit of the University of North Georgia, the department or unit will be directly charged for the service. Requests for officers must be made at least ten (10) business days prior to the event. Making a request for police officer(s) does not guarantee an officer will be provided. If the UNG Police Department is unable to provide the requested number of officers, a notification will be made to the requester no later than 5 business days after receipt of the request.

If an event is canceled and an officer is no longer needed, the requester must notify the UNG Police Department with in 48 HRS prior to the event. If notice of cancellation has not been made within 48 HRS, the requester will be billed half the total cost of the officer.

The undersigned participant hereby waives liability, releases and forever discharges UNG, the UNG Police Department, a division of the Department of Public Safety, and the Board of Regents of the University System of Georgia, its members individually, its officers, agents, or employees from any and all demands, rights, and causes of action of whatever kind or nature, known and unknown, foreseen and unforeseen bodily and personal injuries, damage to property, and the consequences thereof, including death, resulting from my voluntary participation in or in any way connected with such activities.

I further covenant and agree that for the sole consideration stated above I will not sue UNG, the Board of Regents of the University System of Georgia, its members individually, its officers, agents, or employees for any claim for damages arising or growing out of my voluntary participation in such activities.

I understand that the acceptance of this Release, Waiver of Liability, and Covenant Not to Sue UNG or the Board of Regents of the University System of Georgia or any agent or employee thereof, shall not constitute a waiver, in whole or in part, of sovereign or official immunity by said Board, its members, officers, agents, and employees. *

Disclaimer and Release of Liability

(Please Read Carefully) It is requested that the University of North Georgia Police Department, a division of the Department of Public Safety, supply officers for special security for the event listed below. It is understood that the work to be done must be coordinated through the Chief of Police or his designee. Appropriate arrangements will be made through this office to insure that each officer is properly equipped and informed of his/her duties and responsibilities as related to the event. It is understood that the officer(s) working the event are employees of the Police Department and remain under their supervision and control. Any questions should be directed to Deputy Chief Poole at 706-864-1500.

It will be understood that UNG Police Officers will not participate in determining if someone is under the influence or has consumed alcoholic beverages at the direction of the requesting organization or person. The officer(s) will not check identification for the purposes of determining if someone is of age to drink alcohol. This action will only be performed at the discretion of the officer while adhering to the policies and procedures set forth by the UNG Police Department in the officer’s normal duties. Compensation for each officer will be paid by the sponsor of the event at the rate of $42.00 per officer per hour. If the event is less than 3 hours, there will be a minimum fee of $100 per officer.

After the event, actual hours to be compensated will be confirmed by the UNG Police Department and the officer/s will be compensated by the requester. If the requester originates from a department or unit of the University of North Georgia, the department or unit will be directly charged for the service. Requests for officers must be made at least ten (10) business days prior to the event. Making a request for police officer(s) does not guarantee an officer will be provided. If the UNG Police Department is unable to provide the requested number of officers, a notification will be made to the requester no later than 5 business days after receipt of the request.

If an event is canceled and an officer is no longer needed, the requester must notify the UNG Police Department with in 48 HRS prior to the event. If notice of cancellation has not been made within 48 HRS, the requester will be billed half the total cost of the officer.

The undersigned participant hereby waives liability, releases and forever discharges UNG, the UNG Police Department, a division of the Department of Public Safety, and the Board of Regents of the University System of Georgia, its members individually, its officers, agents, or employees from any and all demands, rights, and causes of action of whatever kind or nature, known and unknown, foreseen and unforeseen bodily and personal injuries, damage to property, and the consequences thereof, including death, resulting from my voluntary participation in or in any way connected with such activities.

I further covenant and agree that for the sole consideration stated above I will not sue UNG, the Board of Regents of the University System of Georgia, its members individually, its officers, agents, or employees for any claim for damages arising or growing out of my voluntary participation in such activities.

I understand that the acceptance of this Release, Waiver of Liability, and Covenant Not to Sue UNG or the Board of Regents of the University System of Georgia or any agent or employee thereof, shall not constitute a waiver, in whole or in part, of sovereign or official immunity by said Board, its members, officers, agents, and employees. I certify that I am at least eighteen (18) years of age and suffering under no legal disabilities and that I have read the above carefully before signing. By checking the box, I certify that I have read and agree to the Disclaimer and Release of Liability.
Draw your signature into the box below. *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date * / MM / DD YYYY