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APPLICATION TO HOLD A PUBLIC EVENT

THIS FORM MUST BE COMPLETED AND RETURNED TO: DATE OF APPLICATION:

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NAME OF APPLICANT
ADORESS OF APPLICANT:
CONTACT PERSON(S)

TELEPHONE NUMBER(S) ;

REQUESTS PERMISSION TO HOLD;

TYPE OF EVENT: DATE OF EVENT:
LOCATION OF EVENT: TIME OF EVENT:
ANTICIPATED PARTICIPANTS: ANTICIPATED SPECTATORS
DESCRIPTION OF EVENT:

HAS EVENT BEEN HELD IN THE PAST NUMBER OF YEARS
ANY PREVIOUS INCIDENTS
IF PARADE, COMPLETE THIS SECTION:

NUMBER OF UNITS IN PARADE ON STREET:
ASSEMBLY AREA (ATTACH SKETCH): ON SIDEWALK
DISPERSAL AREA (ATTACH SKETCH}:

ROUTE:

PRINCIPAL CONTACT PERSON, ASSISTANTS, AND TELEPHONE NUMBERS:

INCLUDED IN THIS EVENT WILL BE:
ALCOHOLIC BEVERAGES
FOOO PREPARATION
MERCHANDISE OR FOOD SELLING
TEMPORARY STRUCTURES (STAGES, TENTS, SEATING, ETC.]}
ENTERTAINMENT , EXHIBITIONS OR DEMONSTRATIONS
AMPLIFIED MUSIC/SPEECHES
FIREWORKS
OTHER (EXPLAIN)

IF '¥YES' TS ANSWERED TO ANY OF THE ABOVE QUESTIONS, PLEASE ATTACH A BRIEF
EXPLANATION,

INDEMNIFICATION IN THE FORM OF INSURANCE MUST BE PROVIDED.

TITLE: SIGNATURE: