Special Event Permit Application

form.antibot { display: none !important; } You must have JavaScript enabled to use this form.

Applicant Name *

Business/Organization Name (if applicable)

Address *

Telephone Number *

Email Address *

Event Director/Responsible Person(s)

Event Director/Responsible Person(s) *

Address *

Telephone Number *

Email *

Event

Date of Event

edit-submitted-date-of-event-month

edit-submitted-date-of-event-day

edit-submitted-date-of-event-year

Time of Event *

Approximate Number of Attendees/Participants *

Number of Vehicles *

Complete description and location of event *

Describe any structure(s) to be erected or constructed, including dimensions, location and plans *

Will the event require any use of City right-of-way? *

Yes

If Yes, what is the location and dimension of the proposed City righ-of-way to be used

Plans for your organization to assemble and disperse of the Special Event items, including times, locations, set-up *

All applications shall be accompanied by a nonrefundable Special Event Permit fee as set forth in the city fee schedule ($50.00*)
Permit fee shall not be imposed when all of the following conditions are met:
A. The activities are conducted by a nonprofit organization;
B. The activities are open to the public without discrimination;
C. The activities will benefit the public health safety or welfare; and
D. There is no charge for admission, participation, or a vendor fee (except for pledges for events such as a walkathon). (Ord. 783 § 1, 2005)

* $50 per the City of Medina's Fee Schedule. In addition, the event holder will be responsible for all applicable security costs associated with the event.

Applicant Signature *

Date Submitted

edit-submitted-date-submitted-month

edit-submitted-date-submitted-day

edit-submitted-date-submitted-year

Special Event Permit Application

Upcoming Events

Contact Information