Virginia Beach Parks & Recreation Event Permit Application Page 1 of 6 Return application to: Virginia Beach Parks and Recreation Parks and Natural Areas: Event Permitting 2289 Lynnhaven Parkway Virginia Beach, VA 23456 Event Permit Application Office Use Only: Permit Number: Insurance: Received City purchased Make checks payable to: Virginia Beach City Treasurer Non-Refundable Processing Fee: Received Not Received No changes can be made to this permit once it has been submitted to the Permitting Office. If additional items are needed at a later date, a new Event Permit Application and an additional processing fee may be required. The information requested on this Event Permit Application will be used to determine if the permit will be approved. Completed forms may be released upon the request of any citizen as provided by the Freedom of Information Act. Completion of this form is voluntary; however, failure to complete this form will prevent processing of your application. Any misrepresentation in this Event Permit Application or deviation from the final permit conditions may result in immediate revocation of the permit, the halting of the event, and possible loss of privilege to host events in the future. Note: A layout of the event on a park map indicating all logistical information and submission of a certificate of liability insurance is required with your completed application. On-site meeting may be required. The park will remain open to the general public at all times. Type of Permit Application Due: Processing Fee Large Event Permit *** (5 or more items) 45 Days Prior to Event $300 Event Permit *** (3 or 4 items) 45 Days Prior to Event $200 Special Use Permit *** (up to 2 items) 30 Days Prior to Event $100 Neighborhood Parks 30 Days Prior to Event $50 - $100 ***Items include but not limited to: amplified sound, showmobile, amusements, staging, generator, mechanical rides, pony rides, petting zoo, commercial cookers, live entertainment, food vending, non-food vending, merchandise sales, raffles, etc. Applicant & Organization Information The following information pertains to the person applying for the permit ( Applicant ) Event Name: Event Coordinator : Organization Name: Is this a non-profit? No Yes If yes, attach a copy of the 501c3 certificate or note identification number Street Address: City: State: Zip: Work Phone: Home Phone: E-mail: Cell Phone: Other (hotel, etc.): How should City staff contact Event Coordinator during the event?
Virginia Beach Parks & Recreation Event Permit Application Page 2 of 6 ABOUT THE EVENT AND ENTERTAINMENT Please answer all questions. Indicate N/A if a question does not apply to your event. Please check all that apply. This event is a: Parade Ceremony Fundraiser Picnic Political Rally Concert Skate Park Event Family Reunion Educational / Awareness Freedom of Speech Activity Other: Sporting Event: Please check all that apply. Cross Country (attach a map with the route and include distance) Walk (attach a map with the route and include distance) Run (attach a map with the route and include distance) Soccer Event Location: Mount Trashmore Little Island Great Neck Bayville Farms City View Munden Point Red Wing Woodstock Neighborhood Park (name: ) Other Bike (attach a map with the route and include distance) Beach - Little Island Park Surfing Contest/Camps Fishing Tournament / Clinic / Camp Shelter # (please check all that apply) #1 #2 #3 #4 #5 List locations and dates of prior event held over the last 5 years: Set-up Date: Set-up Start Time: Set-up End Time: Event Date: Event Start Time: Event End Time: Breakdown Date: Breakdown Start Time: Breakdown End Time: EVENT-AT-A-GLANCE Please indicate the various event activities. Please check all that apply. Note: A separate vendor sheet shall be completed for each vendor participating in event. Food Vending / Sampling Inflatable s (must have attendant) Non - Food Vendors (Giveaways, static displays) Generator(s) Live Music, Band, or DJ (song list required) Mechanical Rides(must have attendant) Pony Rides/Petting Zoo (must have attendant) Amplified Sound Purpose:( i.e.; DJ announcements) Staging Show Mobile Tents Bleachers Banners / Signs Raffles / Donations Merchandise Sales Other:
Virginia Beach Parks & Recreation Event Permit Application Page 3 of 6 ATTENDANCE Please check the range of TOTAL anticipated attendance (include spectators and participants): 0 150 150 300 300 450 450-600 600 750 750 1000 Over 1000 SECURITY Security involves crowd control, traffic control, fencing, barricades, etc. Uniformed Virginia Beach Police or Sheriffs Deputies are required for events involving basketball, live music, revenue collection onsite, traffic control and any other events deemed necessary by Police and/or Parks and Recreation. It is the responsibility of the event coordinator to secure the required personnel and pay applicable fees and charges. Payment may be required prior to the event starting. Please describe your security plan: Uniformed presence provided by: Off - duty Va. Beach Police Officers Va. Beach Sherriff s Deputies Number of Security personnel being used for event: Time Security will be onsite: Event Staffing provided by: Private Security Name of Company: Event Staff Name of Company: Volunteers Other: MEDICAL PLAN Are you requesting EMS to remain onsite? Yes No If yes, please contact EMS directly at 385-1999 for details. Please describe, in detail your emergency medical plan?
Virginia Beach Parks & Recreation Event Permit Application Page 4 of 6 FOOD, NON-FOOD, AND OTHER VENDOR INFORMATION FOOD: A food vendor is anyone who is serving, selling or sampling food or beverages. A separate vendor sheet must be completed for each vendor participating in event. Please check all that apply. Check here if there is no food is being served or distributed at your event. Food will be Served to: General Public Event Participants Volunteers Sold Catered: By whom: Prepackaged Giveaways Prepared in a licensed kitchen Location: Delivered from another location Location: Prepared Onsite Will commercial cookers be used? Yes No Please describe your plan for grease and waste water disposal: Food Vendors must be ready at least 1 hour prior to start of event for inspection (i.e.; Health and Fire) NON-FOOD: A Non-Food vendor is anyone selling, demonstrating, or providing a static display for items other than food (ex: t-shirts, educational fliers, merchandise) A separate vendor sheet must be completed for each vendor participating in event. Check here if there are no non-food items being sold or distributed at your event. Will revenue be generated? No Yes Who will benefit from the proceeds? For source of Revenue check all that Apply: Registration Fee Admissions Raffles Donations Souvenirs Merchandise Sales Sponsorship Other: Describe any non-food items to be sold or distributed:
Virginia Beach Parks & Recreation Event Permit Application Page 5 of 6 EVENT LOGISTICS TENTS: Please provide an overview of your tent plan. List each type (by code), number, and size(s) of tents to be utilized for your event. Check here if there are no TENTS being used at your event. TENT CODES: C Cooking underneath S Sales of food, merchandise, etc. GA General Assembly (requires floor plan showing exits) D Displays, information, non-sales Code # of Tents Size of Tents Comments BLEACHERS, STAGING, SCAFFOLDING: Please provide an overview of your bleacher, staging, or scaffolding plan. Check here if there are no BLEACHERS, STAGING OR SCAFFOLDING being used at your event. Size Supplier Supplier Phone # Comments SHOW MOBILE: Additional information available upon request. Check here if you have or plan to reserve the PARKS & RECREATION SHOWMOBILE. RESTROOM AND WASTE DISPOSAL Please indicate on park map the location of trash receptacles and portable restrooms How many trash receptacles will you require? 1 to 5 6 to 10 10 to 20 Check here if there are no PORTABLE RESTROOMS being used at your event. Have you contacted a portable restroom company? No Yes If yes, please provide the company name and an after hours / emergency phone number: #of Portable Restrooms being used: Delivery date of portable restrooms: # of Handicapped Portable Restrooms being used: Pick up date of portable restrooms:
Virginia Beach Parks & Recreation Event Permit Application Page 6 of 6 PARKING AND TRANSPORTATION How will guests/participants be transported to and from the event? Via personal vehicles Other: Where will guests/participants park for the event? Parking lots at the park Overflow or satellite parking location: Where will event support vehicles be parked? Please describe your inclement weather plans: INCLEMENT WEATHER PLANS Permit Conditions The Applicant whose signature appears below agrees to abide by permit conditions resulting from the approval of this application. Hold Harmless Clause Permittee (Applicant/Organization) shall assume all risks incident to or in connection with the permitted activity and shall be solely responsible for damage or injury, of whatever kind of nature, to person or property, directly or indirectly arising out of or in connection with the permitted activity or the conduct of the permittee s operation. Permittee hereby expressly agrees to defend and save the City, its officials, agents, employees, and representatives harmless from any penalties for violation of any law, ordinance, or regulation affection its activity and from any and all claims, suites, losses, damages or injuries directly or indirectly arising out of or in conjunction with the permitted activities or conduct of its operation or resulting from the negligence or intentional acts or omissions of permittee or its officers, agents, and employees. Applicant s Signature: Date: Permitting Office Use Only! On-site required Date: Time: Security / Off-Duty Officers Required Routing City Agencies Required All Permits & Inspections Completed Certificate of Liability Insurance Needed Contact Park Maintenance Park Admin Approval: Park Issues: Time of Inspections: