Special Event Permit Application

Applicant Information
Special Event Permit Application

Special Event Application Fees & Acknowledgement

Processing of your application will commence upon receipt of payment. Please review the fee schedule below for details. Leisure Services staff will be available to assist with online payments, or you may choose to pay in person at Hagen Park.

Special Event Application Fee

5,001+ Participants	$250
5,000 to 1,001 Participants	$200
1,000 to 251 Participants	$150
250 to 101 Participants	$100
Less than 100 Participants	$50
Addition to established event/street festival	$100
Appeal Fee for Denial of Application (non-refundable)	$250

Business/Organization Name (Legal and DBA)*
Business/Organization Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
For ProfitNon-ProfitIndividualOther
Proof of Non-Profit or 501(c)3 Status:

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Primary Contact Person*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Secondary Organization Contact

First NameLast Name
Secondary Contact Phone Number
Please enter a valid phone number.
Secondary Contact Email
example@example.com
Third Organization Contact

First NameLast Name
Third Contact Phone Number
Please enter a valid phone number.
Third Contact Email
example@example.com
Event Information
Event Name: *
Event Location / Address: *
Event Location Description / Type:*
Event Date*

MonthDayYear
Date
Set Up Begin Time:*

Hour Minutes

AM/PM Option
Actual Event Time:*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Cleanup / Load Out End Time*

Hour Minutes

AM/PM Option
Expected Attendance:*
Name of On-Site Contact During Event: *

First NameLast Name
On-Site Contact Phone Number*
Please enter a valid phone number.
YesNo
If yes, describe request:
Event Description & Purpose: *
Be descriptive as to the purpose of the event, what will be happening and what type of equipment will be used.
YesNo
Insurance Limits:
Copy of Commercial General Liability:

($1,000,000 Aggregate/$1,000,000 each occurrence) Please have document list: City of Wilton Manors, 2020 Wilton Drive, Wilton Manors, FL 33305 as named certificate holder and additional insured. The insurance coverage shall be for any and all associated activities related to the event. Certificates of Insurance will be reviewed and approved by the City’s Risk Management Department and may request increased level of coverage based on type of event and attendance.
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YesNo
If yes, please specify the admission price(s):
Alcohol for SaleAlcohol for FreeFood Being SoldFood Being ServedN/A - No food, drink or alcohol
All serving and sales of alcohol require proper licensing according to Florida Law.

All vendors preparing food are required to have a Health Department Permit from a county in Florida and a certificate must accompany vendor at the time of the event. All vendors must adhere to Broward County Health Department guidelines.
Stages and/or PlatformsBleachersGenerators and/or Additional ElectricityAmplified Music and/or SoundPortable ToiletsCanopies and/or TentsDumpsters and/or Additional Trash ServicesOther
Where will event patrons park?*
YesNo
If yes, please specify the location(s) and details:
If requesting street closures, list all affected streets and intersections, including exact dates, times, and any impacts on traffic, detours, or local access.
Site Plan and/or Layout of Event Areas**

Be sure to include event space, parking, trash/dumpsters, stages/platforms, booths, bleachers, music/sound location, and areas with temporary structures such as tents or canopies, fencing, desired entrance and exit areas, areas for portable restrooms, ADA accessible areas. Please be as thorough as possible with site plan.
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Should be Empty:

Applicant Information

Special Event Permit Application

Event Information