2. To hold an event in a Roanoke County park space or picnic shelter, this special use application must be completed and approved by our staff. Special use applications may be submitted up to 6 months in advance of your event. Submissions received within 14 business days of your event may not be considered. If approved, a permit will be issued. Once this form is submitted, please allow 48 hours for our Customer Service Staff to contact you regarding the application.
4. NOTE: SUBMISSION OF THIS APPLICATION DOES NOT CONSTITUTE APPROVAL
6. Primary Event Contact*
7. Organization Name (if applicable)
9. Contact Primary Phone*
10. Contact Email*
12. Primary Contact Date of Birth (MM/DD/YYYY)*
14. Street Address*
15. City*
16. State*
17. Zip Code*
19. Event Type (Please Select All Applicable)*
    -- Select One --Picnic Shelter RentalPrivate EventCommunity EventAthletic / Sport EventRaceProgram / Class / CampVolunteer / CleanupOther
20. If "other" event type, please describe:
22. Park or Facility Requested*
23. Attendance Expected*
25. Event START Date and Time*
    Event START Date and Time

    Event START Date and Time
26. Event END Date and Time*
    Event END Date and Time

    Event END Date and Time
28. Do you plan to charge any attendance or registration fees?*

    1. Yes
    2. No
29. If yes, what is the fee amount per participant?
31. If your event requires setup/cleanup time outside the hours listed above, please specify here:
33. Description of this event:*
35. Upload additional information here such as schedules, race maps:
36. Upload additional information here such as schedules, race maps:
37. Upload additional information here such as schedules, race maps:
39. Roanoke County requires pre-approval for any special amusements, games or special activities such as amusement rides, moon bounces, dunking booths, petting zoos, tents etc. to be set up on County property. The addition of these special activities will require the event to provide a $1 million liability insurance certificate with the Roanoke County Board of Supervisors Named as the Additional Insured.
41. Does your event require pre-approved amusements?*

    1. Yes
    2. No
42. UPLOAD CERTIFICATE OF INSURANCE: If not attached with your application, the certificate must be received within 10 days of your application approval or you will forfeit your reservation.
44. Do you require water or electricity? Check all that apply:

    1. Water
    2. Electricity
45. NOTE: Most sites do not have water or electricity. Please review site amenities at www.RoanokeCountyParks.com
47. Do you plan to serve alcohol at your event?*

    1. Yes
    2. No
48. NOTE: Alcohol permits are available ONLY for Green Hill Park, Explore Park and Camp Roanoke. By checking YES, our special events staff has been notified and will contact you. You will also be responsible for obtaining your own Virginia ABC permit.
50. For additional INTERNAL event application questions, please check this box.

    1. Internal Questions - Roanoke County Staff Only
52. Complete your application by clicking SUBMIT below. Our staff will respond within 14 business days after reviewing your request. Questions? Call our administrative office at (540) 387-6078 ext. 0.
54. Maintenance Support - Please check all of the items needed for this event:

    1. Chairs
    2. Tables
    3. Tents

    1. Parking Support
    2. Portable Toilets
    3. Park Patrol

    1. Mowing Schedule Change
    2. Portable Generators
    3. Mobile Stage
56. How many chairs are needed?
58. How many tables are needed?
60. How many tents and what size?
62. How many additional portable toilets are needed?
64. Which park amenities could be affected by this event? Check all that apply:

    1. Picnic shelter
    2. Ball fields
    3. Tennis or basketball courts

    1. Greenways or trails
    2. Parking lots
    3. Other (specify below under additional maintenance)
66. Please describe any additional maintenance support not specified above:
68. Please describe any marketing support required:
70. Will a staff member be on site the day of the event to help facilitate?

    1. Yes
    2. No
72. Day of Event Staff Name
73. Day of Event Staff Cell Phone
74. Day of Event Staff Email
Leave This Blank:


76. 1. Receive an email copy of this form.
77. Email address

    This field is not part of the form submission.

78. Submit Submit and Print

* indicates a required field