2. Name and Complete Description of the event to include a list of all activities associated with the event and specifics regarding the location(s).*
4. Please attach a detailed map to include the location of the event, event layout, and any requested street/sidewalk closures.
   See the Special Event Information Link for determining whether you must attach a map of the event.
6. What is the date of the event?*
8. What are the planned starting and ending times of the event?*
10. Set-up date and time*
12. Dismantling date and time*
14. Number of staff/volunteers working the event*
16. Estimated number of participants*
18. Is this an event involving political or religious activity intended primarily for the communication or expression of ideas?

    1. Yes
    2. No
20. Will participants pay a fee or make a donation?

    1. Yes
    2. no
22. Name of Organization or Sponsor of the Event?*
24. Has this event been held before? If so, please provide the date and the location.
26. Is the organizer/sponsor of the event a 501c3 non-profit?*

    1. Yes
    2. No
28. If the organizer/sponsor is a non-profit, what is the 501c3 non-profit #?
30. Name and contact information for the event coordinator or person responsible for the event, including mobile phone and valid email address.*
32. List of additional individuals operating the event and their contact phone numbers and/or email.
34. Special Considerations (Additional permits and/or licenses may be required.) Will there be:*

    Please check all that apply.

    1. Amplified Sound
    2. Animals
    3. Booths/Commercial Vendors
    4. Cooking/Food Service
    5. Fire/Pyrotechnics
    6. Inflatables/Amusement Rides
    7. Mechanical Rides
    8. Portable Restrooms
    9. Dumpsters
    10. Signs
    11. Stage
    12. Other Special Considerations
36. Amplified Sound
    If you checked the box designating amplified sound as part of your event, please provide additional details to include: whether the event will contain a concert and if so, the names of the individuals and or groups performing as well as the duration of the need for amplified sound. If the event does not contain a concert, but there is a need for amplified sound, please provide details on the source of the sound. Please provide information on the need for power at the site of the event and if there will be a stage or seating of any kind.
38. If the "Other" box was checked, please describe.
40. Will alcohol be served at the event?*

    1. Yes
    2. No
42. If alcohol is to be served, do you have your permit issued by the Washington State Liquor and Cannabis Board?

    1. Yes
    2. No
44. If there will be 3rd party vendors as part of the event, please provide their names in the field below.
    If there are additions to the list of vendors after submittal, it is up to the organizer to notify the Cheney Parks and Recreation Office.
46. Special Event insurance is mandatory. Will your organization be providing the insurance or do you wish to purchase it from the City?*
48. Will City services be requested for:

    1. Street Closure
    2. Security
    3. Garbage Collection
    4. Sidewalk Closure
    5. Equipment
    6. Parking Restrictions
    7. EMS/Fire
    8. Barricades
    9. Other
50. If the "other" box was checked, please describe the additional service you will be requesting from the City.
52. Upload any additional attachments we will need.
54. Additional attachments
56. Insurance - The City does not maintain insurance that will respond to claims against the applicant in connection with the permitted event by the applicant, its members, or those attending the event. Depending on the type of event you are planning, and the activity and risk level of your group, you may be required to obtain liability insurance in accordance with City policy, name the City as an additional insured on the policy, and be responsible for providing proof of such insurance. After reviewing the application, the City will determine whether you must obtain liability insurance.
58. I hereby certify that I have read and will abide by the rules and regulations set forth by the City of Cheney, Cheney Parks & Recreation Department and in signing this application I hereby agree that I and the organization I represent shall defend, indemnify and hold harmless the City of Cheney, its officers, officials, employees and volunteers from and against any and all claims, suits, actions, or liabilities for injury or death of any person, or for loss or damage to property, which arises out of the acts or omissions of the Applicant , its employees, volunteers, representatives or vendors, or from any activity, work or thing done, permitted, or suffered by Applicant/Permittee/User, related to the permitted activity, except only such injury or damage as shall have been occasioned by the sole negligence of the City. I further agree to promptly reimburse the City of Cheney for any clean up, loss or damage to City property resulting from this use. In addition, I give consent to the disclosure of the phone number(s) I have listed on this application pursuant to request from the public and I give consent to the disclosure of these numbers in informational publications, releases or announcements about his community event.
60. By checking the box below I certify that the information provided is correct and true, and that I agree to the terms and conditions of the special event rules and regulations as specified on this form and in the Special Events Informaton document.*

    1. I agree
Leave This Blank:


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

    This field is not part of the form submission.

64. Submit Submit and Print

* indicates a required field