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VILLAGE OF BROOKLYN
APPLICATION FOR SPECIAL EVENT PERMIT
(For events on Village property with over 100 participants)
Public/special events are governed by village ordinances and organizers are responsible for all necessary permits,
trash and litter pickup, and for damage to any property, as well as possible billing for village services.
The
organization/organizer agrees to be responsible for the supervision of the event and conduct
of
persons present. A
fee of $25.00 and a deposit of $250.00 will apply, except for local non-profit organizations.
Additional fees
may be charged for damage to grounds, buildings, and/or failure to pick up litter generated from
the event.
NAME OF APPLICANT/ORGANIZATION:
Applicant/Organization Name:
Address:
Contact name:_______________________________________________________________
Phone: ___________________________________________________________________________
Email:____________________________________________________________________________
EVENT INFORMATION:
Name/Description of Event___________________________________________________________
Location of Event:__________________________________________________________________
(MUST attach a detailed map or diagram of event, including specific layout)
Date(s) of Event: ___________ Time of Requested Use: ___________
Rain Date:___________________________ Estimated Attendance: _____________
*******************************
I / We do hereby
hold harmless and indemnify the Village and its
Officers, Agents, and Employees against any loss, cost, expense, injury, damage or liability incurred by
reason of any personal injury or property damage sustained by any person, caused or resulting from the
issuance of this permit.
Date:_____________ Applicant Signature:_
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signature
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