APPLICATION TO HOLD A SPECIAL EVENT, RUN, WALK
SPECIAL EVENT & FILM SERVICES
VANCOUVER PARK BOARD (STANLEY DISTRICT)
2099 BEACH AVENUE
VANCOUVER, B.C. V6G 1Z4
TELEPHONE (604) 257-8494 FAX: (604) 257-8501

(VANCOUVER
i PARKS & RECREATION

THIS IS AN APPLICATION/REQUEST ONLY AND DOES NOT GUARANTEE A PERMIT WILL BE ISSUED. TO AVOID ANY
MISUNDERSTANDINGS PLEASE READ TERMS AND CONDITIONS'.
Organization Name:
Name of Event:

F e u

ge

Contact Name:

Glenn

Date of application: 1 0 / 2 8 / 0 3

gallery

Q r u n t

J o j _ e

Purpose of Event: P e r f o r m a n c e
Address:

Alteen

State/Prov: g £

Cit

V: Vancouver

E-mail address:

Cell (

9 5 1 6

):

Is your organization a registered non-profit?
Number of:

YES

grunt@telus.net

Fax: (604) 877
3 NO •

Spectators:

Participants:

nd Ave
Postal code: v 5 T 4R8

Web Site Address: w w w . g r u n t . b c c a
Work:( 6 0 4 ) 8 7 5

_ 350 E a s t

1 1 6

Art

0073

If yes include certificate of society status.

40

Event Related Vehicles:

3_

Full Description of Event: (please attach additional page if needed)
Please read attached d e s c r i p t i o n of event.
. Dispersal Area:,

If a Run or Walk: Assembly Area:

Park & location(s)

|

Date(s)

l Sea Wall byPlaza of l 11/08/2003
Nations

Event time

Set up time

1 8:00pm-ll:00pr|i

7:00pm

Take down time

1 11:30pm

Will you be planning any of the following activities at your event
Food Preparation:
Yes O No (X
Amplified Sound:
Sales of Any Kind:
Yes O N o §
Alcoholic Beverages:
Temporary Structures:
Yes $ No O
Entertainment: (specify)
Other Activities:
Note : Upon Park approval of your event, additional applications & permits

Yes O No (3
Yes O No <3fc
Yes 3 No O a p e r f o r m a n c e w i t h
a f i r e element
will be required from city departments

Are there any services you need to have provided by
• Park Board Staff

• Police

D City Engineering

• Fire

If checked please give details: .
List special services required from the Park Board: (ie: sprinklers off, washrooms, sanitation, etc) Note: Extra cost may apply:

No Special services are required
PLEASE INCLUDE:
•
•
•
•

"

_

~

"

~~

"

A MAP AND SITE PLAN CLEARLY INDICATING THE AREA(S) YOU INTEND TO USE.
A COPY OF YOUR INSURANCE OR A SIGNED PROOF OF INSURANCE COVERAGE FORM FROM ( ATTACHED)
THE PAST FINANCIAL STATEMENT AND CURRENT BUDGET FOR YOUR EVENT
AND IF APPLICABLE, PLEASE CONTACT THE HEALTH DEPARTMENT (736-2866) TO DETERMINE REGULATIONS
REGARDING YOUR FOOD/BEVERAGE AND TOILET REQUIREMENTS.

Revised: September 2003