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Receipt

You will be provided with a Receipt upon submission.

LYH Special Event Permit Application

Event Information

Event Start Date

Date Picker

Event End Date

Date Picker

Event Occurrence

Event Categories (Check all that Apply)

Will Alcohol be Served?

Will there be an admission or entry fee?

Admission/Entry Fee (Check all that apply)

Event/Organization Website

Are you a Non-Profit Organization?

Primary Event Contact

Mailing Address

Secondary Contact or Additional Event Partner

Is another individual, organization, or business sponsoring this activity?

Public Access

Event Time

Noise Information

Alcohol Information

Back-Up Event Date

Date Picker

Public Access

Event Time

Noise Information

Alcohol Information

Event Merchants & Vendors Information

If unnecessary please leave blank. 

Food Served / Sold at Event:

Food Vendor Access

Cooking Method (check all that apply) If Other, please specify.

Retail Vendor Access

Other Vendor Access

Event Venue Set-Up and Break-Down Information

Event Set-Up

Event Break-Down

Will You Be Supplying Any of the Following Items or Elements at Your Event?

If unnecessary please leave blank. If YES, please enter the amount OR description in the text box area. 

Dumpsters

Portable Toilets

Trash Cans

Recycling Cans

Banners or Signs

Fencing

Barricade

Special Lighting

Shuttle Services

Site Decorations

Catered Food

Live Entertainment

Stage, Bleachers, or Other Structures

Fireworks, Fires, or Pyrotechnics

Booths, Exhibits, or Displays

Tents or Canopies

Vehicles/Trailers

Animals

VIP Area

Amplified Music/Sound

Rides/Inflatables, Other Amusement Items

Event Day Staff

Are You Requesting that the City of Lynchburg Provide Any of the Following Items/Elements for Your Event?

Electrical Service

Water Service

First Aid Service

Crowd Control Barricades

Unique Grounds Preparation Needs

Stage. *(note stage is 16’ by 24’; Cost: $750.00; stage has lights and canopy but needs electric)

Other City Services

How Many Staff Persons Will You Have Working the Following Areas:

How do you Plan to Notify Residents and Businesses Who May be Affected by Your Event? Please check all that apply.

How do you Plan to Market/Promote Your Event? Please check all that apply.

Security

For events in downtown Lynchburg, the Department of Parking Management enforces parking rules Monday – Friday from 8 a.m. to 5:00 p.m. If parking is needed in a facility where paid parking is in effect during enforcement times, additional costs may apply to reserve a parking space(s). Please contact Parking Management for information on the Temporary Parking Permit Policy 434-455-4240

Do you request that the Lynchburg Police Department provide security for your event?

Event Parking Information

For events in downtown Lynchburg, the Department of Parking Management enforces parking rules Monday – Friday from 8 a.m. to 5:00 p.m. If parking is needed in a facility where paid parking is in effect during enforcement times, additional costs may apply to reserve a parking space(s). Please contact Parking Management for information on the Temporary Parking Permit Policy 434-455-4240

Will the event be utilizing an off-street public parking facility for the purpose other than public parking?

Will the event be utilizing on-street public parking for the purpose other than public parking? (Examples include stage set-up, tents, reserved VIP parking, additional handicap spaces, vendor parking, etc…)

Please select which City supplied additional items will be needed to re-direct public parking.

Liability Insurance Information

A certificate of insurance for this event must be presented to the City of Lynchburg Office of Economic Development & Tourism Special Events Coordinator) no later than fifteen (15) calendar days prior to the start date of the event. If the information requested below is not available when this application is submitted, it can be added later, but not later than the fifteen (15) day deadline previously noted

Business Address

Indemnity Agreement

In consideration for the City of Lynchburg granting the undersigned Event Organizer representative permission to hold the proposed event on public property and to display, sell, or offer for sale wares, services, and/or food or merchandise within the perimeters of their event venue, the undersigned agrees to assume the defense of and indemnify and save harmless the City, it's employees, offices, and agents against any and all claims, liabilities, judgments, costs, causes of action, damages, expenses, and shall pay all attorney's fees, court costs, and other cost incurred in defending such claims, which may accrue against, be charged to, be recovered from, or sought to be removed from the City, its employees, officers, and agents by reason of or on account of any personal injury or death or damage to property arising from the undersigned's event and associated activities, if such personal injury or death or damage of property is caused by the acts or omissions or negligence of the undersigned, or the undersigned's employees and agents or by such acts, omissions, or negligence of any other person subject to the undersigned's control. The City, its employees, officers, and agents shall not have to give the undersigned any specific types of notices of such claims. 

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