2. 
3. Kinston Police Department Special Event Permit
5. Please review the City of Kinston Special Events Guidelines before submitting your application. This form must be submitted at least fifteen (15) business days before the event, along with the Street Closure Notification Form. Type or print all information. If any questions please contact the Special Event Coordinator Lola Dunn at (252)939-3227 or by email lola.dunn@ci.kinston.nc.us
7. Date Application Submitted:*
8. Event Date(s):*
9. Street Closure Notification Form attached?*

   1. Yes
   2. No
11. Click link to see Guide
    Street Closure Guide
12. Click link to see form
    Street Closure Notification Form
14. Street Closure Notification Upload
18. Event Description and Contact Information
20. Event Name:*
21. Rain Date:
23. Address of Event:*
25. City:*
26. State:*
27. Zip Code:*
29. Please describe your event:*
31. Organization Name:*
33. Telephone:*
34. Website:
36. Address:*
38. City:*
39. State:*
40. Zip Code:*
42. Event Coordinator Name:*
43. Title:*
45. Telephone (onsite during event hours):*
46. Email Address:
47. Non-profit must attach a copy of 501(c)3 status. Is this attached?

    1. Yes
    2. No
49. 501(c)3 Status Upload
53. General Event Information
55. Type of Event (check all appropriate):

    1. Assembly
    2. Car Show
    3. Concert

    1. Festival
    2. Race (Bike)

    1. Race (Foot)
    2. Rally

    1. Parade
    2. Walk-a-thon
57. Note: A map of your event and/or your proposed route (including assembly and disbanding areas) must be attached to this application.
59. Map Upload
61. Please check any special activities that apply to your event.

    1. Amusement Rides
    2. Dunk Tanks

    1. Inflatables
    2. Mobile Stages

    1. Petting Zoo
    2. Pony Rides

    1. Other
63. If other is checked please describe:
65. Is your event open to the general public?

    1. Yes
    2. No
66. Is this a fund raising project?

    1. Yes
    2. No
67. Is this the first time you are holding this event?

    1. Yes
    2. No
69. Total number of expected participants (volunteers, walkers, etc.) and spectators anticipated:
70. Will any public streets need to be fully or partially closed or blocked off?

    1. Yes
    2. No
71. If no, will any sidewalks be closed or blocked off:

    1. Yes
    2. No
73. Please described requested street/sidewalk closures OR attached a detailed map and turn-by-turn directions.
75. Map Upload
77. Street
78. between street
79. and street
81. Street
82. between street
83. and street
85. Street
86. between street
87. and street
89. Street
90. between street
91. and street
93. Will other police services be requested (traffic/parking directions, route layout, etc.)?

    1. Yes
    2. No
94. If yes, explain:
96. Will you have tents?

    1. Yes

    1. No
97. Will any of the tents be over 400 sq. ft.?

    1. Yes

    1. No
99. Reminder: If yes, please contact Kinston Fire Department 252-939-3164
101. What are your plans for providing emergency medical services (choose one)

     1. We are requesting the City to provide EMS services.
     2. This is a small event and we will call 911 if needed.

     1. We plan to use a private EMS company or other Health Services.
103. Is your event location at a city park or on a trail?

     1. Yes

     1. No
104. If yes, contact Parks & Recreation Reservations
106. If at a park or trail, which one (s)?
107. If using a trail, what section (s) do you plan to use: (Attach map if needed)
109. Map Upload
111. How do you plan to handle restroom services:

     1. Portable Toilets
     2. Other
112. If portable toilets will be provided, please list the name/contact of the company:
113. If no portable toilets will be provided, how will these requirements be handled?
115. How do you plan to remove garbage and/or recycling? Reminder: If requesting City receptacles, contact Kinston Public Services
116. What is your plan to provide parking for event attendees? (List locations):
118. Do you plan to sell, distribute or give away food or refreshments? (check all that apply)

     1. Yes (Sell)
     2. Yes (Distribute/Giveaway)

     1. No
119. If yes, please describe:
121. Do you plan to sell or serve alcohol: Reminder: If yes, contact Sergeant S. Jackson 252-939-3184

     1. Yes
     2. No
122. Is Alcohol Permit attached:

     1. Yes
     2. No
123. Alcohol Permit Upload
125. Will security services be needed (required when alcohol is served)? Reminder: If yes, contact Special Event Coordinator Lola Dunn 252-939-3227

     1. Yes

     1. No
127. Type of Alcohol (check all that apply):

     1. Beer
     2. Unfortified Wine
     3. Fortified Wine/Liquor
128. Who is serving/selling alcohol (check all that apply):

     1. Host
     2. Caterer

     1. Other
130. If other is checked above please explain:
131. Is applicant in Compliance with Certification of Insurance Coverage:

     1. Yes

     1. No
133. Is Insurance Policy attached?

     1. Yes

     1. No
134. Insurance Policy Upload
136. Note: The Event Coordinator is responsible for contacting residents and business owners that will be affected by street closing or sidewalk closing prior to or in a reasonable amount of time before the event.
140. Conditions of your Application
142. Submitting this Special Event Permit Application does not provide permission to conduct your planned event. Please do not send out publicity, flyers or other media prior to receiving confirmation of approval. Your confirmation will be in the form of a PERMIT, issued to the organization and/or person responsible for conducting the event. Applicants agree to remove all props and items brought into the public areas and clean up all litter and debris that result from the event the same day as the event (unless explicit arrangements are made otherwise). Issuance of a permit does NOT grant applicants to tow vehicles from reserved or closed areas. Return this application and all supporting documentation to: By Email: lola.dunn@ci.kinston.nc.us 252-939-3227
144. By Mail:
145. In Person:
147. Kinston Police Department
148. Kinston Police Department
150. Attn: Lola Dunn
     P.O. Box 339 Kinston, NC 28502
151. Attn: Lola Dunn
     205 E. King Street Kinston, NC 28501
153. Final approval of the permit will be authorized by the City Council or Chief of Police.
155. CANCELLATION POLICY:
     Written notification of intent to cancel your event must be received in writing a minimum of 21 days prior to the scheduled event date. It should be received by the Special Event Coordinator at the either of the addresses above.
159. Please Sign and Date
     Special Event Permit Agreement

     Please click the link, print form, sign, date form, and then upload it.
161. Agreement Upload
Leave This Blank:


163. 1. Receive an email copy of this form.
164. Email address

     This field is not part of the form submission.

165. Submit

* indicates a required field