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2. Event organizers are required to submit an annual event application no later than 60 days prior to the event, and a certificate of insurance for the event. City Staff must review your completed application before a permit is issued annually. Please use this form for approved annual events. If your event is not listed please submit an event application.

4. Please select your event*
   -- Select One --Downtown Farmers MarketMemorial Day ParadeSuds on SalemLibrary Summer Kickoff EventChamber Concert SeriesBalloon Flyover ParadeCelebrate Warren County ParadeSummer Arts Festival Log Cabin Day ParadePublic Safety Open HouseOktoberfestStorm the NightIndianola High School Homecoming ParadeWine, Witches & BrewsChildren's Halloween Costume PartyLibrary Trunk or TreatHillbilly HikeVeterans Day ParadeHome for the Holidays
6. Contact Person *
8. Phone Number*
9. Email *
11. Event Sponsor*
13. Event Start Date*
    Event Start Date
14. Event End Date
    Event End Date
16. Event Location *
18. Set up begins at *
    Set up begins at
19. Event Begins at*
    Event Begins at
20. Teardown Begins at*
    Teardown Begins at
21. Teardown Ends at*
    Teardown Ends at
23. Safety Plan *

    Please mark each section appropriately. If, in the opinion of the City Clerk, the event, route, street closures, or location (including expanding the site) have substantially changed, a new event application will need to be completed and approved by the City Council.  

    1. There have been no changes to the safety plan, Map A showing the streets/trails/parks/lane closures, locations of barricades/barriers, stages, platforms, events/activities, vendors, parking, etc., Map B showing where vendors and volunteers are expected to park vehicles.
    2. I have made changes, please explain
25. Please describe event changes
27. Noise Permit *

    1. I am submitting a noise permit application. The application is available on the City's website under "How Do I" apply for noise permit. Please attach below.
    2. I am not submitting a noise permit application
29. Noise Permit Application
31. Suspension of Indianola Code 47.01(11)*

    If the applicant is requesting suspension of enforcement of Indianola Codes 45.02(2) or 47.01(11) both regarding the sale and consumption of alcohol upon City property and in City Parks, the City Council will need to approve this request by resolution each year. 

    1. I am not requesting suspension of Indianola Code 45.02(2) or 47.01(11)
    2. I am requesting suspension of Indianola Code 45.02(2) or 47.01(11). Add description below.
33. Please state location for suspension of Indianola Code 45.02(2) or 47.01(11).
35. Restroom Rental *

    For events held in the Square, the applicant may rent the hallway bathrooms at 114 North Howard. A $60 rental fee will be charged to the applicant and a $50 security deposit. The security deposit is used to cover extra cleaning, lost keys, or other damages. Should the cleaning fees, damages, or replacement of lost keys exceed the deposit amount, the event organizer shall be responsible for the additional fees. The deposit may be refunded if the facility is left in an acceptable condition and the keys are returned to City Hall the first business day following the event.

    Keys for the facility may be picked up during regular business hours at City Hall.

    If the event is canceled within 24 hours, the fee and deposit shall be refunded to the applicant. If the event is canceled on the day of the event (for any reason except inclement weather), or if the applicant fails to pick up the key, the fee will not be refunded.

    All refunds are issued as a check.

    1. I am requesting to rent the restrooms
    2. I am not requesting to rent the restrooms
37. Is this a City Sponsored event? *
    -- Select One --YESNO
39. Insurance Certificate*

    Please include an insurance certificate showing the City as an additional insured in the amount of $1,000,000 or more. 

41. Electronic Signature
43. Submission Date*
    Submission Date
Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit

* indicates a required field