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2. Instructions
   Use this form to register for a block party. Block parties must be registered at least two weeks in advance. Please note that block parties are subject to visits from your elected officials. A "block party" means that every household on the designated block is welcome to attend. The City does not provide block party assistance (providing barricades, street sweeping, etc.) for private parties. Your request will be confirmed.
   
   
4. Notes:
   —The Mayor and members of Council enjoy engaging with our residents and may drop by your party depending on their availability.
   
   —In the event the block party is cancelled or rescheduled due to weather, please notify our staff by 11 am on the day of the event. Erin Rose can be reached at erin.rose@shakeronline.com.
8. About the Event
10. Type of Event
    -- Select One --Block celebrationIce cream socialChurch activitySchool activityPTO activityOther
12. If Other, please explain.*
14. Date of Event*
    Date of Event
15. Start & End Time of Event*
    Start & End Time of Event Start Time

    —

    Start & End Time of Event End Time
    Please indicate when block party activities start and end, not when the barricades will go up (see below).
16. Approximate Meal Time
    Approximate Meal Time
18. Frequency of Event*
    -- Select One --AnnuallyWeekly2-4 Times AnnuallyMonthly
20. Will you have a food truck?*

    Please note that food trucks must follow the guidelines outlined in 546.01 – 546.03, and 1111.05 of the City’s ordinances.

    1. Yes
    2. No
22. Street to Be Blocked Off*
24. Cross Streets
    Please indicate the cross streets at either end of the street -- or section of street -- to be blocked off.
26. Cross Street 1*
27. Cross Street 2*
29. Is the celebration for multiple streets?*

    1. Yes
    2. No
30. If Yes, what other streets are invited?
32. Is this a rescheduled block party due to inclement weather at a previously scheduled block party?*

    1. Yes
    2. No
36. Request for Barricades*

    Select the number of barricades needed to block the street.

    1. 2 Barricades (Street is a dead end; needed at one end only)
    2. 4 Barricades (Intersections are average size; 2 on each end)
    3. 6 Barricades (At least one intersection is large enough to require 3)
37. Approximately what time will you put up/take down the barricades?*
    Approximately what time will you put up/take down the barricades? Start Time

    —

    Approximately what time will you put up/take down the barricades? End Time
41. Contact Information
43. First Name*
44. Last Name*
46. Address*
48. Phone Number*
49. Email Address*
53. Alternate Contact First Name
54. Alternate Contact Last Name
56. Alternate Contact Address
58. Alternate Contact Phone Number
59. Alternate Contact Email Address
63. Special Requests
    Based on availability.
65. Police Dog*

    1. Yes
    2. No
66. Police Car*

    1. Yes
    2. No
67. Fire Truck*

    1. Yes
    2. No
68. Mayor or City Council*

    1. Yes
    2. No
70. Additional Requests / Information
72. Do you have a rain date?*

    1. Yes
    2. No
73. If yes, when is the rain date?*
    If yes, when is the rain date?
75. Cancellation/Rescheduling Instructions:
    In the event the block party is cancelled or rescheduled due to weather, please notify our staff by 11 am on the day of the event. Erin Rose can be reached at erin.rose@shakeronline.com.
Leave This Blank:


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

    This field is not part of the form submission.

79. Submit

* indicates a required field