[City of Pocatello] Special Event Permit Application

Special Event Permit Application

Instructions

Prior to completing this form, you must read the Conditions of the Special Events/Concession Permit (PDF) document. Afterward, thoroughly answer every question on the application. Once you have completed the form and attached all applicable documents, your application will be reviewed by Parks & Recreation staff who will contact you.

Organization Information

Organization Name

Tax-Exempt Status

For Profit

Nonprofit (proof required)

Contact Information

Event Coordinator Phone

Event Coordinator Email

Secondary Contact Phone

Event Information

Name of Event

Description of Event

Event Location

Expected Attendance

Under 50

50 – 99

100 – 199

200+

Date(s) of Event

Starting and Ending Times of Event (not including setup or teardown)

Setup and Teardown Times of Event

Number of vendors expected to participate in the event

The event coordinator must collect all COMPLETED vendor concession applications, required additional documents, and permit fees for submission to the Parks & Recreation Department at least 10 days PRIOR to the event.

Special Requirements

Merchandising Information

Will your organization be advertising, selling, collecting donations, or giving away any items*?

Yes

Are any of the items food or beverages?

Yes

Please refer to our Conditions of the Special Events/Concession Permit document regarding obtaining a license exemption from Southeast Idaho Public Health.

PLEASE NOTE: All food and beverage concession units must have a conveniently accessible trash container capable of holding all trash and garbage generated by the operation of the concession.

Will an OUTSIDE VENDOR be advertising, selling, collecting donations, or giving away the items on behalf of your organization?

Yes

Vendors catering/serving food for an event on behalf of your group MUST fill out one of our Vendor Concession Permit Applications, obtain written approval from the Southeast Idaho Public Health, and provide liability insurance (see Conditions of the Special Events/Concession Permit for detailed information). If the catering/providing vendor is not accepting/collecting a fee for their services, there is no charge for their concession permit.

DETAILED listing of items being advertised, sold, or given away

DETAILED description of the concession to be used (i.e. stand, cart, trailer, table w/canopy, etc.). Dimensions of any free standing unit are required.

Photo or drawing of unit (in lieu of description)

Click Here to Upload

Attachments

Attach a copy of your Public Liability Insurance (minimum of $1,000,000) naming the City of Pocatello as an additional insured AND proof of nonprofit status (if applicable).

Proof of Public Liability Insurance

Click Here to Upload

Proof of Nonprofit Status

Click Here to Upload

Health Department Permit or Exemption

Click Here to Upload

Terms of Agreement

Permits will NOT be issued until all documents and fees are received by the Parks & Recreation Department.

Acknowledgement

I have read the Conditions of the Special Events/Concession Permit document and understand and agree to abide by those conditions, pay the applicable fees, and will provide any additional permits/documentation required for this application. I certify that there are no misrepresentations, omissions, or falsifications in the foregoing statements and answers and that the entries made by me are true, complete, and correct to the best of my knowledge and are made in good faith.

Applicant Signature

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.