Submitting this form is only a request, not a guarantee of reservation or approval.

Reservation requests will be reviewed for location safety and are processed in the order they are received.

 

Contact Information

 *

Contact Information

Full Name	Address	City/State
Zip	Daytime Phoneext.	Email

Date of Block Party (mm/dd/yyyy)

 *

Date of Block Party (mm/dd/yyyy)

1st Date Preference

2nd Date Preference

3rd Date Preference

Trailer Delivery Address

 *

Trailer Delivery Address

Time and Street Closures

 *

Time and Street Closures

Start Time (including AM or PM)	End Time (including AM or PM)	Street Name to Close
Street Closed from Address/Location	Street Closed to Address/Location

Request Visit from Police and/or Fire Department

Request Visit from Police and/or Fire Department

None

Police Department

Fire Department

Request Visit from City Council Member(s)

Request Visit from City Council Member(s)

None

Ward 1: Bronwyn Beatty-Hansen

Ward 2: Tim Gartin

Ward 3: Gloria Betcher

Ward 4: Rachel Junck

At-Large: Anita Rollins

At-Large: Amber Corrieri

Other Special Instructions

Other Special Instructions

E-Signature

 *

I certify that I am 18 years of age or older. I am a resident of the City of Ames. I acknowledge that I have read, understand, and agree to abide by the trailer guidelines. I agree to be liable for any loss or damage to the Block Party Trailer and its contents. I agree to defend and hold the City of Ames harmless from liability in case of accident or injury.

 

If you do not receive a message that your application was successfully submitted, please
review the form to make sure you have completed all required fields.

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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