2. 
4. What Requires a A Special Event?
   Request For Special Event
6. Date of Application
8. Applicant Information
10. Event Host
11. Name of Applicant
13. Street Address
14. City
15. State
16. Zip
18. Daytime Phone
19. Cell Phone
21. Evening Phone
22. Email address
24. On-Site Contact
25. On-Site Cell Phone
27. Billing Contact
28. Billing Address
30. Event Information
32. Type of Event (Please check all that apply)*

    1. For Profit
    2. Non Profit
    3. Competition
    4. Festival

    1. Walk/Run Footrace
    2. Concert
    3. Parade
    4. Carnival

    1. Farmers Market
    2. Rally/Demonstration
    3. Other
34. Is this a*

    1. One-Time Event
    2. Monthly Event
    3. Annual Event
36. Event Name*
37. Proposed Date of Event*
39. Requested Park/Area
40. Alternate Date of Event
42. Event Setup
43. Date and Time
    Date and Time

    Date and Time
45. Day One
46. Start Time
47. End Time
49. Day Two
50. Start Time
51. End Time
53. Event teardown Start Time*
54. End Time
56. Streets to be closed for Event
    (Specify on Site Map)
58. SITEMAP
    Your application will not be reviewed if a site map is not included with your application. All site maps are subject to the approval of City of Ponca City. The map must show the locations of the following items, if applicable.
60. Please Check all that apply

    1. Beer Sale Location
    2. Event Headquarters
    3. Parking Areas
    4. Security Tent
    5. Street Closures
    6. Carnival Rides

    1. Fencing
    2. Public Entry Areas
    3. Sign Banner Placement
    4. Trash Receptacles/Dumpsters
    5. Emergency Access Points

    1. First Aid Tents
    2. Restrooms(Port a Potties)
    3. Stage/Amplified Sound
    4. Vendor Booths
    5. Other pertinent Details
62. Route Map
    Your application will not be reviewed if a route map is not included with your application. If your event is a run, walk, bike race or other activity in which participants follow a course, you must attach a separate map of the proposed route. All proposed routes are subject to Parks & Recreation approval and use of any space outside the park (such as city streets) must be approved by the municipality. Events cannot close any city streets, roads or parkways using volunteers or event staff. Routes cannot be marked on cement or pathways. Spray paint and Spray Chalk are only permitted on grass areas with prior approval for the Director.
64. Expected Number of Participants*
65. Expected number of Spectators
67. Will participant registration be capped?*

    1. Yes
    2. No
68. What is the registration capped at?
70. Is your event a timed race?

    1. Yes
    2. No
71. Are you marking your course?

    1. Yes
    2. No
72. Does your route cross any roads or parkways?

    (Please show on route map)

    1. Yes
    2. No
73. Are you requesting any road closures

    (Please show on route map)

    1. Yes
    2. No
75. Alcohol
77. Are you planning on serving alcohol at your event?*

    1. Yes
    2. No
78. Are you planning on selling alcohol at your event?*

    1. Yes
    2. No
79. If yes, you must obtain any local, county, and/or state permits and follow applicable liquor laws.
81. Sales and Sampling
    Please answer the following questions as it pertains to Ponca City Parks & Recreation Property
83. Selling Food?*

    1. Yes
    2. No
84. Selling Non‐Alcoholic Beverages?*

    1. Yes
    2. No
85. Selling Merchandise?*

    1. Yes
    2. No
86. Will you be charging admission on event date?*

    1. Yes
    2. No
88. Will you be holding a silent auction/raffle?*

    1. Yes
    2. No
89. Will samples be distributed at no cost?*

    1. Yes
    2. No
90. Describe
92. Provide a list of vendors, if applicable, one week prior to the event date.
94. PAVILION AREA(S) OR SHELTER REQUEST
    Submitting a special event request does not guarantee pavilion/shelter availability. Please indicate below the pavilion and/or shelter you intend to use. Fee will apply.
96. Pavilion/Shelter #*
97. Date(s)*
99. Time(s)*

    1. 8am-12pm
    2. 12:30pm-4:30pm
    3. 5pm-9pm
101. Amplified Sound
102. (Amplified Sound cannot begin before 8:00 AM including sound checks)
104. Will you have amplified sound?*

     1. Yes
     2. No
105. Start Time
106. Hours of amplification(including sound check)

     1. AM
     2. PM
107. End Time
109. DJ*

     1. Yes
     2. No
110. Band*

     1. Yes
     2. No
111. Type of Music played
113. Amplified sound must be directed away from residences. Amplified sound must comply with municipal code 7-1-9A of the City of Ponca City Code. It is the responsibility of the Event Organizer to provide electrical power to support the event.
115. PORTABLE RESTROOMS
     Applicant is responsible for providing sufficient portable restrooms to accommodate the size of the event. One portable restroom for every 100 people is required for all special events that do not provide beverages and one portable restrooms for every 50 people is required for special events providing beverages. Parks & Recreation restroom facilities are available March 1st to October 31st for events under 250 people.
117. EQUIPMENT REQUESTS
119. Trash Receptacles*

     1. Yes
     2. No
120. Quantity Requested
121. Dumpsters (if available)*

     1. Yes
     2. No
122. Quantity Requested
124. Barricades*

     1. Yes
     2. No
125. Quantity Requested
126. Picnic Tables*

     1. Yes
     2. No
127. Quantity Requested
     For city sponsored events only
129. City Stage*

     Fee Required

     1. Yes
     2. No
130. Date Requested
132. Structures
     Do you plan on installing or using any of the following structures: banners, fencing, stages or tents. It is the responsibility of the host organization to obtain these structures.
134. Will you be bringing in a stage? *

     1. Yes
     2. No
135. Will you be using tents or canopies?*

     1. Yes
     2. No
136. Quantity
137. Size
139. Please be advised, staking of tents is ABSOLUTELY PROHIBITED without prior approval from the Director. Tents and/or canopies must be secured with sand bags or water barrels. If approved for staking the event organizer is responsible for contacting Okie811 Hotline at (800) 522‐6543.
141. Security Plan
     Depending on the size and activities of your proposed event, Parks & Recreation may require the presence of security at your event. Ponca City Police Department presence may also be required at your event.
143. Have you made provisions for on-site security services? *

     1. Yes
     2. No
144. Will you have overnight security at your event?*

     1. Yes
     2. No
146. Security Company
147. Contact Name
149. Cell Phone
150. Email
152. Medical Services*

     Have you made provisions for on-site medical services?

     1. Yes
     2. No
154. Medical Company
155. Contact Name
156. Cell Phone
157. Email
159. Indemnification
     The event organizer agrees at all times during the existence of the event requested herein to indemnify the City of Ponca City for, and hold it harmless from all liability, claims and demands on account of personal injuries, property damage and loss of any kind whatsoever, including workers’ compensation claims, which arise out of or are in any manner connected to this request, based on any injury, damage or loss being caused by any wrongful, intentional, or negligent acts or omissions of the event organizer, its agents or employees. Event organizer shall, at its own expense, investigate all claims and demands, attend to their settlement or disposition, defend all actions based thereon and pay all charges of attorneys and other costs and expenses arising from any such injury, damage or loss, claim, demand or action.
161. Signature
     The event organizer named above will be responsible for the conduct of the group and for the condition of the reserved area. This event is subject to all municipal codes in addition to all rules and regulations governing parks and parkways. The applicant agrees that, while using the park facility, the sponsoring organization will not exclude anyone from participation in, deny anyone the benefits of, or otherwise subject anyone to discrimination because of the person’s race, color, national origin or handicap. I do solemnly swear (or affirm) that all answers given and statements made on this application are full and true to the best of my knowledge and beliefs. I have read the terms and conditions outlined in this document and agree to abide by them.
163. Name of Applicant*

     (print name)

164. Signature of Applicant
165. Date
169. For Official Use Only
171. Date Received
172. Approved
173. Denied
175. Date of Event
177. Approved by
Leave This Blank:


179. Submit Submit and Print

* indicates a required field