Special Events Co-ordinator Form

Please complete and submit this form at least 45 days prior to the event. Notifications may not be accepted/reviewed after this time.

Event name

Event location/address

Event start date

Event end date

Event set-up date

Event set-up time

Expected attendance

Will there be food vendors?

Yes

No

Will personal services be offered? (e.g. tattooing, piercing, manicures, pedicures, waxing and hair services etc.)?

Yes

No

Is this an annual event?

Yes

No

Have you held an event already this year? If so, name and date of the event (please provide more details in the comments)

Event Coordinator Contact Information

Event coordinator name

Event coordinator email

Event co-ordinator phone number

Extension

Event Details

Method of providing water to vendors

Municipal

Bottled

Hauled

Well

Other

Will you provide garbage disposal for vendors

No

Yes

Method of waste water disposal

Method of grease/oil disposal

Will you provide hydro/electricity for vendors

No

Yes

Will you provide bathrooms and handwashing stations for those in attendance?

No

Yes

Will water activities be present? (e.g. dunk tank)

No

Yes

Will there be a petting zoo or animals present at the event?

No

Yes

Site Plan

Please upload a copy of the site plan and include the placement of:

Food Vendors
Personal Service Setting Vendors
Washroom Facilties
Hand Wash Stations
Electrical Sources
Waste Water Disposal
Garbage Disposal

Please upload a copy of the site plan

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Additional comments

Region of Waterloo Form

Special Events Co-ordinator Form

Event Coordinator Contact Information

Event Details

Site Plan