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City of Clearwater Public Communications, Neighborhoods Division
Block Party Permit Application
General Event Information:

The purpose of block parties is to increase neighborhood participation, to provide an opportunity for neighbors to meet each other and to promote community spirit. A block party may not be held to promote religious, political or special individual interests, such as birthday parties.

Applications must be filed at least 15 days prior to the date of the event.

If you have questions regarding this block party application process, please contact Anna Gurney, Neighborhood Liaison at Anna.Gurney@myclearwater.com or call 562-4554.

By checking the below boxes, you acknowledge that you have read, understand, and will comply with these statements and/or rules (required):











Date of Application:  Calendar icon                       Block Party Date:  Calendar icon                      
Neighborhood Association Name:

Authorized Person in Charge:     
Authorized Person's Address (including City, State, and Zip Code):
Phone Number:

E-mail Address:
Please describe your neighborhood:





Location of Event (please be specific):

Hours of Event:
Setup Begin Time:   Breakdown Completion Time:  
Purpose of Event (Why is the Block Party Taking Place?):
Description/Activities of Event (What are the Details/Operations of the Block Party?):

Estimated Number of Participants:
Event Components and Activities (Select ALL that apply):

If yes, Hours of Play: 


If yes, Number of Tents and Sizes: 


If yes, How many: 


If yes, Name of Street to be Closed:

               Intersecting street, from:

                                             to:

Barricades are required for blocked streets and events. They may be rented by applicant from private vendors.
One lane must remain clear and accessible to emergency vehicles at all times per Florida Fire Prevention Code.
Request for City Officials/Department Representatives to Attend (Select ALL that apply):









     Please specify any special requests of officials/departments selected above:
    
If city personnel are requested at your event, please note their attendance cannot be guaranteed. Emergency personnel may be called for service.
Applicant Certification (required):
I hereby certify that I have read this application and that all information contained herein is true and correct to the best of my knowledge, information and belief. I agree to comply with all Statutes, County and City Ordinances, and the general instructions stated in this application. I further understand that failure to comply with any of the provisions specified herein, or the unauthorized modifications of any event parameter, may result in immediate cancellation of this event by City officials. Applicant must be 18 years of age or older.

If you have questions, please call or email Anna Gurney at (727) 562-4554 or Anna.Gurney@myclearwater.com


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