Request to Plan Special Event

Name of Proposed Event *

Point of Contact Name *

Point of Contact Email *

Point of Contact Phone Number *

Is an Ardsley department or board/committee sponsoring this event? *

Yes

Unsure

This would apply to any events sponsored and planned by the Parks and Recreation Department as well as the MDI and CAC committees

Identify the Village-affiliated department or board *

Ardsley Parks and Recreation Department

Multicultural, Diversity and Inclusion Committee (MDI)

Climate Advisory Committee (CAC)

Date of Event *

Month

Day

Year

Start Time *

Hour

Minute

Enter the time the event will start

End time *

Hour

Minute

Will you require additional time for set up/clean up? *

Yes

Unsure

How much additional time will you need? *

Enter the amount of set up and clean up time you will need

What is the location of the event? *

Provide the name of the Park or Facility

How many people are expected to attend? *

Will any neighbors or businesses be impacted?

Yes

Unsure

Will there be any residual impact to neighbors and businesses resulting from the event?

If yes, please specify entity and impact *

Who is responsible for notifying the above impacted parties? *

Is Highway Department support required? *

Yes

Unsure

Will you require Highway Department support prior to, during or after event?

What Highway dept. support do you need? *

Support during event set up and clean up

Garbage/Recycling Collection

Road Closure Barriers

Outline what support you will need from the highway department?

Is Police oversight/support required? *

Yes

Unsure

Will you require police department staff to attend?

What Police Support will you need? *

Road Closures

Parking and Traffic Assistance

Crowd Control

Periodic Patrols

Click all that apply

Is your event taking place outside? *

Yes

Is your event taking place outside?

Will you need access to utilities like electricity or water? *

Water

Electricity

Not Sure

Do you need access to a water source or electricity?

Will you require access to restroom facilities? *

Yes

Unsure

Let us know if you will need access to restroom facilities at a park?

Will alcohol be served? *

Yes

Will alcohol of any kind be served at this event?

Will food be served? *

Yes

Who will be providing the food? *

Store bought packaged food served by event organizers

Food prepared off-site and delivered to the event and distributed by event organizers

On-site Food Truck(s)

On-site Caterer

Store bought and packaged food can be provided by event organizers without requiring any food permits. Any food that must be prepared and cooked requires a temporary food permit from the Westchester County Department of Health if it is being served directly by event organizers. In addition, any food that needs to be reheated, kept warm or cold also requires a temporary food permit it is served by the event organizers. Contact Charles Hessler at chessler@ardsleyvillage.com to access this temporary food permit. If ordering food from a vendor who will be vending or serving food on site during the event, they must have their catering permit OR this ability on their food operating permit. If you are bringing in a food truck or caterer, the Village must confirm that they have this permit. Please indicate who will be preparing and distributing the food at the event below. Mark all that apply.

Please list the supplies that will need to be purchased by the Village? *

Will you need tables/chairs/tents? *

Yes

Let us know if you will need the Parks and Recreation Department to provide tables, chairs or tents. Please note that these items may be in limited supply.

How many chairs do you need?

How many tables do you need?

How many tents do you need?

Media Outreach

Yes

Will you need any media outreach to advertise your event?

Which of the following will you need? *

Indicate which of the following you will need to advertise your event. Mark all that apply

Leave this field blank

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Request to Plan Special Event