• I certify that the information set forth within this application is complete, true and correct to the best of my knowledge and belief, and that I have reviewed and will comply with the requirements set forth in the Street Event Planning Guide. Information from your application is considered public information and may be used in developing a calendar of community events. Acceptance of your application should in no way be construed as final approval or confirmation of your request. The City of Phoenix reserves the right to refuse the application and it is revocable if deemed in the best interest of the City of Phoenix.
• *Applicant Name:
• Applicant Title:
• Date:
• *I understand and agree
  

• Event Information

• *Type of Event March Procession Parade Concert Farmers Market Athletic Festival Run Walk Run and Walk Motorcycle Ride Bicycle Ride Other
• *Event Title
• *Event Date
• *Day(s) of Week: Sunday Monday Tuesday Wednesday Thursday Friday Saturday
  
• *Street Closures/Restrictions Requested (Be specific)
• *Estimated Attendance per Day:
• *Donation/Registration/Participation Fee?
  Yes No
• *Amount?
  
• *Actual Event Hours:
• *Set up Date(s):
• *Times:
• *Tear Down Date(s):
• *Times:
• Is this considered to be an annual event?
  Yes No
  
• Is any city of Phoenix department co-sponsoring this event? If yes, please provide employee name and contact number:
  

• Applicant & Event Organization Information

• *Name of Organization (The organization name MUST match the Insurance certificate holder name)
  
• *Name of Event Coordinator
  
• *First Name
• *Last Name
• *Address
• *City
• *State
• *ZIP
• *Phone: (include area code)
• Fax:(include area code)
• Cell Phone (include area code)
• *E-mail
• *Responsible person "on-site" day of event:
• Cell Phone (include area code)
• 
  
• Are you using a professional event organizer?
  Yes No
• If you are using professional event organizer to work on your behalf to plan, produce and/or manage this event, please provide contact information here:
• Professional Organizer First Name
• Professional Organizer Last Name
• Address
• City
• State
• ZIP
• Phone: (include area code)
• Fax:(include area code)
• E-mail
• 
  

• Event Details

• Event open to the public? Yes No
  
• Public contact's phone and e-mail:
• Event information Web site:
• Will public official(s) be invited to the event? Explain:
• Please check/answer the following that apply to your event:

• *Alcohol? No         Free         Sold (Special Events Liquor License Required)

• Event Maintenance / Clean-up

• It is the responsibility of the event organizer to ensure trash is picked up during and at the conclusion of the event. Event organizer is responsible for all trash on the event site and any trash associated with the event or event patrons or spectators that impact the surrounding area, adjacent streets, right-of-way, neighborhood home owners property, schools, businesses or places of worship.
  *I understand and agree

• Public Safety / Security

• Responsible person on site
• Work Phone: (include area code)
• Cell Phone:(include area code)
• Describe your plan for on-site security:
• Will you be requesting off duty Phoenix police officers? There is a cost associated with off duty (off-duty coordinator – 602-262-7323, TTY 602-262-6151)
  Yes No
• 
  After reviewing the application, the City reserves the right to require the use of off-duty police officers at the expense of the organization.

• Street Closures/Event Parking

  Right-of-Way Management Program (RMP) for City of Phoenix must be followed. Completed RMP form must be submitted. Form and list of barricade companies certified to do business in Phoenix can be obtained by calling 602-262-6235, TTY 602-256-4286. A detailed description/route map must be submitted upon request.
• Street closures requested?
  Yes No
• Name of contracted certified barricade company:
• Contact Name:
• Phone:

This application form can be provided in an alternate format upon request. Call 602-262-6862 (voice) or 602-262-6713 (TTY). 602-732-2315 (FAX). E-mail: Receptionist.PKS@phoenix.gov

The City of Phoenix prohibits discrimination on the basis of race, ethnicity, national origin, sex, religion, age, sexual orientation, or disability in its services, programs and activities. Anyone who believes he or she has been discriminated against may file a complaint with the City of Phoenix Equal Opportunity Department.

Before you submit this e-mail form, we would like you to be aware of the City's policy on the use of its e-mail systems. The policy states that the e-mail message you are about to send: (1) is subject to public disclosure under the Public Records Law, (2) is not private or confidential and (3) is retained for one month.