Neighborhood Block Party

Neighborhood Block Party

Permit Application
Form Guidelines

Application Timeline

Please submit this application at least thirty (30) days prior to your event.

Permit Fee

The permit fee associated with this application is fifty dollars ($50.00).
Special Events Office - Contact

All questions regarding this permit application should be directed to:
- Gina Fisher, gina.fisher@greensboro-nc.gov, (336) 373-4572

Applicant Information
Applicant Name*

First NameLast Name
Applicant Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applicant Cell Phone*
Please enter a valid phone number.
Applicant Email*
example@example.com
Date of Birth*

MonthDayYear
This is required for payment collection via WebTrac.
Organization Name
Only if applicable.

Event Information
Event Name*
Event Start Date & Time*

MonthDayYear
Date
Hour MinutesAM/PM Option
Event End Date & Time*

MonthDayYear
Date
Hour MinutesAM/PM Option
Estimated Attendance *
Inclement Weather / Rain Date(s)
Provide both start and end dates, as well as times.
Event Description*
Event Location*
Provide the intersection, street(s), park, neighborhood, etc. where the event will be held.
Would you like to request City trash/recycling cans?

YesNo
How many of each can is needed?
On Site Contact Name*

First NameLast Name
On Site Contact Cell Phone*
Please enter a valid phone number.
Primary Event URL
Website, Facebook Event, etc.

Third-Party Food Vendors
Have you invited any food vendors (food trucks, food tents. catering companies, etc.) to participate in your event?

YesNo
Food Vendor List*
If you have more than three (3) food vendors, you will need to fill out a Special Event Permit Application instead.

Street Closure #1

	Response
Name of Street to be Closed
Beginning Point / Intersection
Ending Point / Intersection
Closure Start Date & Time
Closure End Date & Time

Street Closure #2

	Response
Name of Street to be Closed
Beginning Point / Intersection
Ending Point / Intersection
Closure Start Date & Time
Closure End Date & Time

Street Closure #3

	Response
Name of Street to be Closed
Beginning Point / Intersection
Ending Point / Intersection
Closure Start Date & Time
Closure End Date & Time

Will street parking be affected?*

YesNo
Planned parking areas:*
Please provide as much detail as possible. Provide neighborhood name, bordering streets, pre-existing parking options, or any other location that will be utilized for parking by event attendees.

Liability Waiver
Release of Liability Waiver (Individual)

I, {name}, acknowledge that I am not covered by any City of Greensboro insurance policy, and that I agree to hold the City of Greensboro, its officers, its employees, and its agents harmless from any and all claims, losses, damages, or liability arising out of or proximately caused by the undersigned from any activity, including the cost of defense of claim and attorney's fees.
Release of Liability Waiver (Organization)

I, {name}, representing {organizationName}, acknowledge that I am not covered by any City of Greensboro insurance policy, and that our organization agrees to hold the City of Greensboro, its officers, its employees, and its agents harmless from any and all claims, losses, damages, or liability arising out of or proximately caused by the undersigned from any activity, including the cost of defense of claim and attorney's fees.
Date*

MonthDayYear
Date
Signature*

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Certifications
Special Event Permit

If your event requires one of the activities stated above, you will need to pursue a Special Event Permit instead of a Neighborhood Block Party Permit.

Questions?

Contact the City of Greensboro Special Events Office.
- Gina Fisher, gina.fisher@greensboro-nc.gov, (336) 373-4572
The Special Events Office can provide both business and residential notification forms upon request.

Applicant Information