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Applicant Information

Instructions
Complete the following application in full to receive consideration for a Special Events Permit at least 3 months in advance of the event. You will be contacted to pay a $50 application fee. Application submission does NOT constitute event approval. Approved applicants will be notified.
If you have a firm date in mind for your event, please email events@fallschurchva.gov to confirm availability prior to submitting the application.
Applicant's Name*
Organization Name (if applicable)
Mailing Address: Street, City, State*
Phone Number*
Email*
If the organization is a non-profit, please choose the type below.
1. Charitable
2. Church, Religious, or Faith-Based
3. Private
4. Political
5. Other
If the organization has a 501(c)3 Employer Identification Number (EIN), please enter it here.
Is the event to be held by, on behalf of, or for any person other than the applicant?*
1. Yes
2. No
If yes, please explain.
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Basic Event Information

Event Logistics

Emergency Response Plan

Event Organizers will be required to provide a formal, written special event emergency response plan that identifies potential emergency conditions that may occur at the event site and describes the procedures that will be followed to minimize risk and prevent loss of life and property.

This plan needs to provide specifics that include emergency evacuation plans, event organizers contact information and lists staff/volunteers who will be assigned to specific locations in case of an emergency with a map with emergency exits.
Upload your Emergency Response Plan.*
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Acknowledgement and Signatures

Release and Indemnity*
1. Yes, I agree.
Each applicant must execute the release and indemnity agreement that will be included in the Event Acceptance Packet. Applicants must demonstrate that they are either personally or organizationally responsible for liability, will guarantee orderly behavior, and will underwrite any damage due to the use of the premises. Liability is assumed by the applicant in regards to any personal or property damage rising out of activities of the applicant. It is the responsibility of the applicant to read this documentation and the application form completely and understand fully his/her responsibilities.
Agreement*
1. Yes, I agree.
I, acting on behalf of the organization I represent, state that I am legally authorized to agree to abide by the rules, regulations and guidelines specified herein, and that I will accept all responsibilities for any damage to City Property and/or facilities, any payments for municipal services and/or resources as they have been outlined and as they may be utilized by me and the organization whom I am representing and the patrons who will be served by this Special Event. I also understand that the falsification or misrepresentation of any information on this application may result in the immediate termination or cancellation of this event at the sole discretion of an authorized representative of the City of Falls Church. I understand that I am responsible for meeting all the requirements of my special event as set forth by the City of Falls Church. I understand it is my responsibility to provide proof of adequate liability insurance to the City of Falls Church. I also understand and agree to all City ordinances, state and federal laws, rules and regulations.
Application and Guidelines*
1. Yes, we agree.
The applicant certifies that the information in this application is true to the best of their knowledge. The applicant also certifies that they have read and understood the Special Event Application Rules and Regulations (separate document).
Event Policy*
1. Yes, I understand.
I understand the City of Falls Church has the right to cancel, postpone, or modify the event due to weather, natural disasters, pandemics, or other unforeseeable circumstances.
Electronic Signature*
By checking "I Agree," you agree and acknowledge your electronic signature is valid and binding in the same force and effect as a handwritten signature.
1. I Agree

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1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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