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Step One

TITLE, PURPOSE AND BRIEF DESCRIPTION OF EVENT:
TYPE OF APPLICATION
1. New Application
2. Renewal of or Change of Information
REFER MEDIA OR CITIZEN INQUIRES TO:
EMAIL ADDRESS:
PHONE NUMBER (PRIMARY):
PHONE NUMBER (SECONDARY):
APPLICANT AUTHORIZATION:
Attach a written communication from the organization or organizations in whose name the event will be advertised which authorizes you, the applicant, to apply for the special events permit on its or their behalf.
Applicant’s Name:
Title
Address
City
State
Zip Code
Is Your Mailing Address the Same as the Address Above?
1. Yes
2. No
Address
City
State
Zip Code
Affiliation:
Phone Number (Day):
Phone Number (Night):
Phone Number (Emergency):
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EVENT PRINCIPALS

REQUESTED EVENT COMPONENTS:

Requested Day and Date (first choice):
Requested Day and Date (first choice): Start Date
—
Requested Day and Date (first choice): End Date
Alternative Day and Date
Alternative Day and Date Start Date
—
Alternative Day and Date End Date
Alternative Day and Date
Alternative Day and Date Start Date
—
Alternative Day and Date End Date
Requested hours of operation, from:
Set up beginning day and date:
Set up beginning day and date:
Set up beginning day and date:
Dismantle by day and date:
Dismantle by day and date:
Dismantle by day and date:
Describe the number and type of animals to be used in the event:
Anticipated number of participants:
Anticipated number of spectators:
Attach a draft of the entry form for participants/spectators:
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INSURANCE AND SANITATION

INSURANCE:
Attach to this application either an insurance policy or a certificate of insurance including the policy number, amount and the provision that the Town is included as an additional insured. (Please note that insurance requirements depend upon the risk level of the event. Also, if your event can be classified as First Amendment expressive activity, insurance requirements can be waived by the Town Council under certain circumstances.)
SANITATION:
Attach your “Plan for Clean/up Material Preservation.” Include number, type and location of trash containers to be provided for the event. Indicate who and how many will be responsible for emptying and cleaning up around containers during the event. Indicate who and how many will be responsible for cleaning up the event area after the event. Describe the number, type and location of portable toilets to be provided for the event area after the event. Describe the number, type and location of portable toilets to be provided for the event (or permanent toilets to be used for the event). Include any other plan you have for ensuring post-event cleanliness and material preservation of city facilities, equipment, premises and streets.
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LOCATION MAP:

AVAILABILITY OF FOOD, BEVERAGES AND/OR ENTERTAINMENT:

If there will be music, sound amplification or any other noise impact, please describe, including the intended hours, the music, sound, or noise.
Alcoholic beverages to be served?
1. Yes
2. No
Describe what system will be used to ensure that alcoholic beverages will be consumed only by those persons 21 years and older.
Describe how, where, when and by whom the alcoholic beverages will be served.
Attach to the application a copy of your permit from the State Alcoholic Beverage Control Board. Alcohol may not be served without a permit.
If a casino party, a dance, or live entertainment is part of your event, please describe.
Please describe all of the activities of your event for which a business license is required.
Food and/or non-alcoholic beverages to be served?
1. Yes
2. No
Describe sanitation measures, food handling procedures, and the nature of the food (such as pre-packaged foods, hot dogs, pre-mixed sodas, unpeeled fruit, raw meats, vegetables, fish or peeled and cut fruit).
You may need to have a health permit for the County Department of Health Services. Attach a copy of your health permit to this application.
If you intend to cook food in the event area, describe your area layout, including fuel or electrical source to be used.
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SECURITY AND SAFETY PROCEDURES:

Describe your proposed procedures for set up, operation, internal security and crowd control.
If the event is to occur at night, describe how you are going to light the event in order to increase the safety of participants and spectators coming to and leaving the event.
If you event includes vehicles or animals, describe the minimum and maximum speeds of the event and the minimum and maximum intervals of space to be maintained between units.
Attach to this application a copy of your building permit (or permits) if you are installing any electrical wiring on a temporary or permanent basis and/or if you are building any temporary or permanent structures such as bleachers, scaffolding, a grandstand, reviewing stands, stages or platforms.
Attach a copy of your fire department permit or permits to this application if you will use parade floats; an open flame; fireworks or pyrotechnics; vehicle fuel; cooking facilities; enclosures (and tables within those enclosures); tents, air- supported structures, canopies, or any fabric shelters.
Give name, address and phone numbers of the agency or agencies which will provide first-aid staff and equipment. Attach an additional PDF if necessary.
Name of Agency:
Name of Representative:
Address
City
State
Zip Code
Phone Number (Day):
Phone Number (Evening):
Phone Number (Other):
Indicate medical services that will be provided for the event.
1. Ambulance
2. Doctors
3. Nurses
4. Paramedics
How will ambulance be provided?
How will doctors be provided?
How will nurses be provided?
How will paramedics be provided?
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VENDORS OR CONCESSIONAIRES:

Describe what vendors or concessionaires you will allow in conjunction with the event and the purpose or purposes of these concessions:
Describe how you intend to regulate, monitor and control the type, number and quality of vendors/concessionaires whom you may permit to operate in conjunction with the event:
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MITIGATION OF THE IMPACT ON OTHERS:

Describe how you intend to mitigate the impact of the special events on businesses, churches, neighbors, motorists, mass transit users and others. Attach additional sheets, if necessary, entitled “Mitigation of the Impact on Others":
Attach additional files here:
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TOWN SERVICES/EQUIPMENT:

Describe town services and/or equipment requested for this event. Town barricades, cones, and no-parking signs may be borrowed on an as-available basis. You should plan to pick up and return this equipment. If you or your volunteers cannot pick up and return this equipment, please attach a letter requesting these services and explaining why your organization cannot perform them. This will be reviewed and approved or denied by the special events coordinator:
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OTHER PERTINENT INFORMATION:

Any additional pertinent information:
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OPTIONAL INFORMATION:

The following information is not required for permit approval. It is requested so that the Town will have data, in the future, of the dollars raised for charities, the estimated age groups of participants and spectators, the fees charged or donations required and the specific public benefits derived from each event.
Estimate percentage of age groups for participants and spectators:
Age 15 years & under Participants:
Age 15 years & under Spectators:
16 to 25 years Participants:
16 to 25 years Spectators:
26 to 45 years Participants:
26 to 45 years Spectators:
46 years & older Participants:
46 years & older Spectators:
If there is a fee or donation required as a condition of attendance or participation in this event, please describe the amounts to be collected from various categories or participants or spectators:
Application #:

Leave This Blank:

1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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Town of Boone Special Event Application

Steps

Step One

EVENT PRINCIPALS

REQUESTED EVENT COMPONENTS:

INSURANCE AND SANITATION

LOCATION MAP:

AVAILABILITY OF FOOD, BEVERAGES AND/OR ENTERTAINMENT:

SECURITY AND SAFETY PROCEDURES:

VENDORS OR CONCESSIONAIRES:

MITIGATION OF THE IMPACT ON OTHERS:

TOWN SERVICES/EQUIPMENT:

OTHER PERTINENT INFORMATION:

OPTIONAL INFORMATION:

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