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Special Event Coordinator Event Registration Form/Application (Web Form)
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Requirements
Guidance on Special Events (PDF)
Special Events Inspection Checklist
Inspection Checklist
Permit Exemptions
Permit Exemptions
Promotional Sampling
Promotional Sampling
COVID-19
Guidance
Event Information
Event Start Date/Time
*
Event Start Date/Time
Event Start Date/Time
Event End Date/Time
*
Event End Date/Time
Event End Date/Time
Food Service Start Date/Time
*
Food Service Start Date/Time
Food Service Start Date/Time
(please indicate the date and time when food vendors will serve food)
Estimated public attendance:
*
Event Name
*
(please provide full unabbreviated event name)
Event Address:
*
City:
*
Zip Code
*
Coordinator Name
*
Coordinator Phone
*
Coordinator Email
*
Coordinator phone number during event:
*
Cell phone is preferred.
Is a vendor meeting planned?
*
Yes
No
Date/Time of Vendor Meeting
Date/Time of Vendor Meeting
Date/Time of Vendor Meeting
If yes, please provide the address of the vendor meeting:
Property Owner Information
The Maricopa County Environmental Health Code requires the property owner of an event location, or his/her designee, to register any event with the Environmental Services Department at least 30 days prior to the start of the event. Additionally, it is the property owner's responsibility to ensure that all food service vendors have obtained all applicable Department permits. Failure to do so may result in legal action against the property owner and/or their designee.
Property Owner Name
Owner Address
City
State
Zip Code
Owner Phone Number
Owner Fax Number
Owner Email Address
General Information
Anticipated number of food/beverage vendors:
*
Will an approved potable water source be provided onsite for vendors?
*
Yes
No
If yes, please describe source:
Will wastewater disposal services be provided onsite for vendors?
*
Yes
No
If yes, please describe services:
Will grease/oil disposal services be provided onsite for vendors?
*
Yes
No
If yes, please describe services:
Will trash/refuse disposal services be provided onsite for vendors
*
Yes
No
If yes, please describe services:
Will an electricity source be provided onsite for vendors?
*
Yes
No
If yes, please describe source:
Will back-up refrigerated storage be provided onsite for vendors:
*
Yes
No
If yes, please describe equipment/facilities:
Will animals be present at the event (petting zoo, rodeo, etc.)?
*
Yes
No
Please be aware that a mobile food establishment shall not be located within 100 feet of any petting, riding or holding area for animals unless dust and runoff are controlled.
Restroom facilities:
*
Public Restroom
Chemical Toilets
Temporary toilet facilities shall not be located within 25 feet of any mobile food establishment.
Chemical toilet company:
Number of chemical toilets provided:
Do you have a dust control plan?
*
Yes
No
Having a plan in place for inclement weather is encouraged. Food/beverages must be protected from dust/other contaminants at all times.
Are parking/entry passes needed for inspectors to gain access to the event?
*
Yes
No
If yes, please describe:
Please attach full list of food/beverage vendors who will be attending event.
List must include all food/beverage vendors including any promotional vendors offering samples. The list must also include all business names, owner names, addresses, phone numbers, menus, and permit numbers (if applicable).
Vendor List Template
Vendor List Spreadsheet
Please attach map of event site with vendor locations and support facilities:
I hereby certify that the above information is correct, agree to comply with the Maricopa County Environmental Health Code, agree to allow the regulatory authority access to the establishment as specified under 8-402.11 and to the records specified under 3-203.12 and 5-205.13 and Subparagraph 8-201.14(D)(6), and I fully understand that any deviation from the above without prior permission from the Maricopa County Environmental Services Department may nullify final approval. By checking the check box and typing your name you have digitally signed this application.
I agree the application is true and correct.
I agree
Disclaimer
Information entered on this form will be retained by Maricopa Environmental Services Department and is a record as defined by Arizona law. This form will be provided without redaction in response to a public record request unless any of the information is exempt from release under Arizona law.
Signature
Date
Date
Once our staff has reviewed your form you may receive a follow-up email/call to clarify details provided on this form.
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Email address
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