Request For Event Planning Information
CONTACT INFORMATION
Full Name
Cell Phone
Daytime Phone
Address
City
State
Zip Code
Email
Sponsored by
For Profit
Yes
No
SUMMARY OF EVENT
Is this your first time using this online form?
Yes
No
How many forms do you plan to submit today?
Event Title
Event Start Date
End Date
Rain Date(if applicable)
Event Start Time
AM
PM
Event End Time
AM
PM
Area
- Select -
Aldie
Arcola
Ashburn
Bluemont
Dulles
Hamilton
Hillsboro
Lansdowne
Leesburg
Lovettsville
Lucketts
Middleburg
Neersville
Philomont
Purcellville
Round Hill
South Riding
Sterling
Waterford
Other
Event Street Address
Event Venue Name
Event Type
ATHLETIC/SPORTING
CARNIVAL/CIRCUS
CONCERT
FAIR/FESTIVAL
PARADE
RUN/WALK
WEDDING
OTHER, PLEASE SPECIFY
Event Description
(Please provide a written description of your event, including the purpose of your event. Maximum 600 characters.)
Anticipated Crowd
Anticipated Participants
Select
Yes
No
N/A
Is this an annual event?
If YES, how many years have you been holding this event?
Select
Yes
No
N/A
Is this the same event being conducted under a different name?
If YES, what was the event previously titled?
Select
Yes
No
N/A
Will there be attendees traveling from outside of Loudoun County?
Select
Yes
No
N/A
Will you need assistance identifying lodging or hotel accommodations for your event?
ORGANIZATIONAL STATUS/PROCEEDS/REPORTING/MARKETING
Select
Yes
No
N/A
Is the event Sponsor/Organizer registered with the Office of Consumer Affairs at the Virginia Department of Agriculture and Consumer Services?
Select
Yes
No
N/A
Does the Event Sponsor/Organizer have a Letter of Tax Exemption from the IRS?
Select
Yes
No
N/A
Are patron admission, entry, or participant fees required?
If YES, please provide amounts:
Select
Yes
No
N/A
Are vendor or other fees required?
If YES, please provide amounts:
Select
Yes
No
N/A
Will any sales activity be conducted?
ENTERTAINMENT AND RELATED ACTIVITIES
Select
Yes
No
N/A
Will inflatables, mechanical rides or similar devices be used at your event?
Select
Yes
No
N/A
Will your event include the construction of portable structures, pre-fabricated structures, or site-built structures such as bleachers, elevated platforms, temporary pedestrian bridges, tent structures, etc.? If YES, please specify:
Select
Yes
No
N/A
Will there be any use of fireworks, lasers, black powder or other pyrotechnics?
Select
Yes
No
N/A
Will your event include the use of signs, banners, decorations, or special lighting?
Select
Yes
No
N/A
Will your event include the use of generator's for power distribution?
If SO, please provide the number and size of the generators:
Select
Yes
No
N/A
Are there any musical entertainment features related to your event?
If YES, please specify: Number of stages; Stage type: Mobile or Constructed; Number of Performers/Bands; Music Type.
Select
Yes
No
N/A
Will sound checks be conducted prior to the event?
If YES, specify Start Time and End Time:
Select
Yes
No
N/A
Will sound amplification be used?
FOOD CONCESSIONS AND PREPARATION
Select
Yes
No
N/A
Does your event involve the use, sale or consumption of alcoholic beverages? If YES, please check:
free/host alcohol
alcohol sales
beer
wine
beer & wine
beer, wine & distilled spirits
Select
Yes
No
N/A
Does your event include food concessions and/or preparation areas?
How many Food Vendors do you expect?
Select
Yes
No
N/A
Do you intend to cook food in the event area?
If YES, please specify the method:
Propane/Natural Gas
Electric
Charcoal
Other (specify)
Specify Other
SANITATION AND RECYCLING
Select
Yes
No
N/A
Do you plan to provide portable restrooms facilities at your event?
If YES, please specify total # of portable toilets, and # of ADA accessible portable toilets.
Please note one (1) portable toilet per 100 guests at the peak attendance of your event is the guideline.
Select
Yes
No
N/A
Do you plan to provide handwashing stations at your event?
If YES, please advise total number of handwashing stations:
Select
Yes
No
N/A
Is there a plan for trash disposal? If
YES
please specify: (1) number of trash cans; (2) number of dumpsters; (3) collection frequency
Select
Yes
No
N/A
Is there a plan for collecting recyclables? If
YES
please specify: (1) what will be collected for recycling; (2) number of recycling bins; (3) number of dumpsters; (4) collection frequency;
PUBLIC SAFETY AND TRANSPORTATION
Select
Yes
No
N/A
Are animals involved in any aspect of your event?
Select
Yes
No
N/A
Will tents be erected larger than 20 X 20?
Select
Yes
No
N/A
Have you addressed mechanisms for crowd control, internal security, or venue safety through your security planning?
Select
Yes
No
N/A
Have you contacted a Fire and/or Emergency Medical Services (EMS) agency for coverage at your event?
If YES, what company have you been in contact with?
Select
Yes
No
N/A
Do you intend to use any portion of the Washington and Old Dominion Trail (W & OD Trail) during your event?
If Yes – Have you contacted the Park Manager of the W & OD Trail?
Select
Yes
No
N/A
Select
Yes
No
N/A
Do you have inclement weather evacuation plan? If no, the development of a plan is necessary for outdoor events taking into account weather monitoring, public notification and appropriate actions to take during severe weather.
Select
Yes
No
N/A
Will any streets need to be closed?
Select
Yes
No
N/A
Will vehicular traffic or pedestrians be entering or exiting onto public roadways?
Select
Yes
No
N/A
Will traffic be blocked or rerouted?
Select
Yes
No
N/A
Will your event involve the use of offsite parking areas and/or shuttle plan? If so, the development of a parking/shuttle plan is necessary to ensure coordination, communication, and weather planning.
ADA ACCESSIBILITY
I affirm that I have read, understand, and agree to the following statement:
(Required!)
There will be a clear path of travel throughout the event venue.
We have developed a disabled parking and/or transportation plan (including public transportation or shuttle services) for the event.
A minimum of a 10% of portable restrooms at the event will be accessible.
All food, beverage, and vending areas will be accessible.
All signage will be provided in highly contrasting colors and places so pedestrian flow will not obstruct its visibility.
If an information center is provided at our event, customer service representatives will be available to assist disabled individuals.
If all areas of our event cannot be made accessible, maps or programs will be made available to show the location of accessible restrooms, parking, vendor's, and first aid stations.
MITIGATION OF IMPACT / PUBLIC RELATIONS
Select
Yes
No
N/A
Have you presented your event concept to the officially recognized community groups that are in/near the venue area?
Select
Yes
No
N/A
Have you met with the residents, business, and places of worship, schools and other entities that may be directly impacted by your event? If YES, please provide a complete list of these entities. (max 300 characters)
Select
Yes
No
N/A
Will this event be marketed, promoted, or advertised in any manner?
If YES, please provide the variety of methods for delivery including website address, Facebook page, Twitter page and other devices. (max 300 characters)
Select
Yes
No
N/A
Will there be live media coverage during the event? If YES, please provide the media outlets covering your event:
Select
Yes
No
N/A
Will media vehicles be parked within the event venue? If YES, please provide number and location of vehicles:
Special Notes or Questions: (max 600 characters)