Maricopa County Environmental Services Department
Environmental Health Permitting Services Program
Phone: (602)506-6824
SpecialEvents@maricopa.gov
esd.maricopa.gov
http://www.maricopa.gov/2505/Locations-Hours
Special Event Coordinator Event Registration Form
Event Name (unabbreviated)
Event Address
City
Arizona
Zip Code
Coordinator Name
Coordinator Email
Coordinator Phone
Coordinator Cell Phone During Event
Date/Time of Vendor Meeting (if planned)
Provide address for Vendor Meeting (if planned)
Event Start Date Food Service Start Date
Estimated Public Attendence
Property Owner Information
The Maricopa County Environmental Health Code requires the property owner of an event location, or his/her designee, to register any event
with the Environmental Services Department at least 30 days prior to the start of the event. Additionally, it is the property owner's
responsibility to ensure that all food service vendors have obtained all applicable Department permits. Failure to do so may result in legal
action against the property owner and/or their designee.
Property Owner Name
Owner Address
City
Arizona
Zip Code
Owner Email Owner Phone
Provide the following with this form:
Vendor List (Sample vendor list) List must include all food/beverage vendors including any promotional vendors offering samples. The
list must also include all business names, owner names, addresses, phone numbers, menus, and permit numbers (if applicable).
Map of event/vendor locations
Event Information
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Event End Date
Event Start Time Event End Time Food Service Start Time
