Event Application Form | City of Plattsburgh, New York

Do I need to complete an Event Application?

If you wish to hold your event on any portion of outdoor property owned by the city including: Roads/road allowance, parks, parking lots, open spaces, walkways, marina, etc. and the event includes any of the following elements: road closures, food being given or sold to the general public, alcohol, fireworks, sound amplification, tents, amusements rides, use of electricity and fencing.

You do not need to submit an event application if your event does not include any of the above elements; however, if you want to reserve the space for your event and ensure no other events are being held in that location at the same time, it is advised that you submit an event application.

Until this event is approved by the City of Plattsburgh staff, event organizers are advised not to announce, advertise or promote this event. The use of the City of Plattsburgh logo is strictly prohibited unless written permission is obtained.

Main Point of Contact Information

First

Last

Phone Number

Email Address

Address

City/Town

State/Province

ZIP/Postal Code

Is your group a non-profit/charitable organization?

Yes

What is your charitable donation number?

Event Details

Location of Event

Brief Description of Event

Type of Event (check all that apply)

Moving Event (Walk/Run/Parade/Bike Ride)

Free Public Event with no sale of food and/or goods

Free Public Event with sale of food and/or goods

Event with Alcohol

Tournament

Music Event

Demonstration

Street Solicitation

Other…

Event Date and Start Time

Set Up Date and Set Up Time

End Date and Time

Please answer the following questions about your event. Based on your answers, you may be required to apply for additional permits and approvals.

Does your event require street closures?

Yes

What roads and intersections will be closed?

Will your event require tents or signs that are staked into the ground?

Yes

Will there be food and/or non-alcoholic beverages served at this event?

Yes

Will there be alcohol served at this event?

Yes

Equipment and Facility Needs

Questions	Yes	No
Power Required?	Yes	No
Water Required?	Yes	No
City Beach Stage Required?	Yes	No
Garbage Cans Required?	Yes	No
BMI/ASCAP Required?	Yes	No
Will there be fireworks?	Yes	No
Will there be people selling non-food products?	Yes	No

Attendee Information

Estimated Attendance

Admission Fee

Emergency Management

Designated Emergency Liaison (on Event Day)

Phone Number

Alternate Emergency Liaison (on Event Day)

Phone Number

By signing, you do hereby hold and save harmless and agree to indemnify the City of Plattsburgh and its elected officials, directors, officers, employees, servants, agents, contractors and their respective heirs, executors, successors with respect to any and all actions, debts, suits, demands, costs, damages and expenses whatsoever arising either directly or indirectly as a result of the rental/use of the facility/park.

I have read and understand the Municipal Events Procedures and I will abide by all guidelines therein.

Signature

Sign above

Complete your application by clicking the submit button below. You can print a copy of this form and mail it or drop it off to the address below. Please allow for up to 5 business days for a response.

Mayor's Office
Attn: Community Engagement Coordinator
41 City Hall Place
Plattsburgh, NY 12901