Special Event Permit Application Form - Boston Parks And Recreation Department
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2BOSTON PARKS AND RECREATION DEPARTMENT
Special Event Permit Application
1010 Massachusetts Avenue, Boston, MA 02118
Telephone: (617) 961-3054 Fax: (617) 635-3227
APPLICANT AND SPONSORING ORGANIZATION INFORMATION
Please complete all data as required.
NAME OF ORGANIZATION: ________________________________________________________________________________
APPLICANT NAME: ________________________________________________________________________________________
ADDRESS: ______________________________________CITY: _________________________STATE: ______ZIP____________
DAYTIME PHONE: (____)________________ EVE. PHONE: (____)___________________ FAX#: (____)__________________
E-MAIL: _______________________________Web Page: ___________________________________________________________
MANAGER ON SITE DAY OF EVENT: ______________________________ PAGER/CELLULAR: (____)_________________
*Any change in the above information, please notify the Parks Department immediately.
SPECIAL EVENT INFORMATION
Complete all data as required for event of any size.
Type of Event:
____--RUN/WALK
___RALLY
___PARADE
___WEDDING CEREMONY/PHOTOS
___FAIR
___CONCERT
___PICNIC
___OTHER (specify): ______________
EVENT TITLE: ____________________________________________________________________________________________
EVENT DATE(s): ___________________________________________ESTIMATED ATTENDANCE______________________
REQUESTED PARK: _______________________________________________________________________________________
AREA OF PARK (Describe Physical Boundaries): ________________________________________________________________
ACTUAL HOURS OF EVENT: ________________AM/PM - _______________AM/PM
SET UP TIMES: _______AM/PM - _______AM/PM
TAKE DOWN TIMES: _______AM/PM - _______AM/PM
DESCRIPTION OF EVENT SET UP: __________________________________________________________________________
__________________________________________________________________________________________________________
Please attach additional sheets as necessary, including plans, drawings, maps, etc.
PLEASE INDICATE WHETHER THE FOLLOWING ITEMS PERTAIN TO YOUR EVENT.
YES
NO
____
____
FOOD CONCESSION AND/OR FOOD PREPARATION AREA (S)
(IF YOU INTEND TO COOK FOOD IN THE EVENT AREA)
PLEASE SPECIFY METHOD: ___GAS ___ELECTRIC ___CHARCOAL ___OTHER: ___________________________
____
____
FIRST AID FACILITY (IES) AND AMBULANCE (S)
____
____
WILL YOU SET UP TABLE (S) AND/OR CHAIR (S) HOW MANY?:___________________________________________
____
____
FENCING, BARRIER (S) AND/OR BARRICADE (S)
____
____
DOES YOUR EVENT REQUIRE ELECTRICITY? SOURCE:_________________________________________________
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Boston Parks and Recreation Department Special Event Application
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