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Special Event Application

Special Event Application

First Name
Last Name

Organization Name
Address
City
State
Zip Code

Phone
Email

Event Information

Name of Event
Event Location
Park name and location within park, if applicable
Start Date
Start Time
End Date
End Time
Description of Event
Provide specific details of the event including any fees charged and what programs the event profits (if any) will support.
Estimated Attendance
Include event staff & volunteers
The Event Will Have
Check all that apply
Liability Waiver
First Aid Kit(s)
On-Site Emergency Services
Emergency Action Plan
Special Accommodations Needed
Check all that apply
Shelter Reservation
Group Campsite Reservation
Nature Center Reservation
Shooting Range Reservation
Traffic/Parking Control
On-Site Law Enforcement
Firewood
Electricity

Conservation

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Des Moines County, Iowa
513 N Main St.
Burlington, IA 52601
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Department Hours May Vary
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