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 alcoholalcohol salesbeerwinebeer & winebeer, 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 GasElectricCharcoalOther (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)