Special Event Request 2022

CONTACT INFORMATION

Event/Activity Name	---
Facility (See link to park locations and descriptions above)	---
***Other Description	Chelsea Square
Event Date	08/30/2022
Applicants Name	---
Contact Person	---
Email Address	---
Cell Phone	---
Day Phone	---
Billing Address	---

EVENT INFORMATION

Name of Supervisor/Vendor on Site	---
Supervisor / Vendor Phone Number	+16038280640
Name of Second Supervisor on Site	---
Second Supervisor Phone Number	+16033977930
Total Estimated Number of Participants	4
Estimated Number of ADULT Participants	4
Estimated Number of YOUTH Participants	0
Organization Type	Commercial Group
Activity	Other (please specify below)
Brief Description of Event	---
Special Requirements	---

First Preference For Event Date

Is this event happening on one date or multiple dates?

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First preference: Single Date - Time

Date	2022-08-30
Total Time (ex. 2:00pm-6:00pm)	---
Set-up Time (ex. 2:00pm-3:00pm)	---
Total Event Time (ex. 3:00pm-5:30pm)	---
Breakdown Time (ex. 5:30pm-6:00pm)	n/a

Second Choice - Single Date

If your first choice date is not available, do you have a second choice?

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Second Preference: One Date

Total Time (ex. 2:00pm-6:00pm	---
Set-up Time (ex. 2:00pm-3:00pm)	---
Total Event Time (ex. 3:00pm-5:30pm)	---
Breakdown Time (5:30pm-6:00pm)	---
Facility (please see link above for park locations and descriptions)	---

Specialized Event

Does your event fall under one of these categories?

No

Licensing Department and Inspectional Services Department

Are any of the following part of your event?

None of these will be part of my event.

Department of Public Works

Will you require lighting? (Please call 617-466-4200 during business hours, and 617-828-7327 after hours).)	---
Will you require use of restrooms, if available?	---

Additional Information

Please list any additional Special Requirements

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