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2. Contact Information
4. First Name*
5. Last Name*
7. Organization (If Applicable)
9. Phone Number*
10. Email Address*
12. Street Address*
14. Street Address
16. City*
17. State*
18. Zip*
22. Block Party Information
24. Date of Event*
    Date of Event Start Date

    Date of Event Start Time

    —

    Date of Event End Date

    Date of Event End Time

    Block party may be held between 8 a.m. and 10 p.m.

26. Estimated Number of Attendees*
28. Street to be Closed*
30. From (Cross Street)*
31. To (Cross Street)*

33. Please note that block parties are only allowed on unclassified neighborhood streets. Streets noted with a thin grey line are eligible for block parties. 

    For street classification information, please refer to WSDOT’s Classification System.

    Block parties may be feasible on minor or major collector streets, but would require further administrative review through the Special Events permit process. Please note that the Special Events permit process requires a fee and a longer review time.

35. What do you plan to use to block the street?*
37. Is this a special occasion?*
39. Is the street part of an Homeowners Association (HOA)?*
    -- Select One --YesNo
40. Has the HOA been notified of the event?*
    -- Select One --YesNoNot part of an HOA
42. I attest that I will notify my neighbors of this event and provide local vehicle access as necessary.*

    1. Yes
44. I attest that I will be present onsite during the event and will provide emergency vehicle access as necessary.*

    1. Yes
46. I attest that — with the exception of the movable street barricades — no equipment utilized during the event will impede a 20 ft lane for emergency vehicle access.*

    1. Yes
48. I acknowledge that alcohol is not permitted in public streets or on the public right of way.*

    1. Yes
50. I acknowledge that I am responsible for the removal of all trash from the right of way following the party.*

    1. Yes
54. Emergency Service Invitations
56. Request a visit from Issaquah Police Department?*
    -- Select One --YesNo

57. If you wish to request a visit from Eastside Fire & Rescue, please submit this form with two weeks advance notice.

59. Please note that we cannot guarantee Police or Fire availability for your event. Depending on service demands and calls for service, they will try and stop by your event, if requested.

63. Event Activities
65. Check all block party activities that apply:

    1. Amplified Music
    2. Inflatable Bouncers (inflatables are not allowed on City property)
    3. Tents/Canopies (tents over 400 s.f. require a permit)
67. Describe any additional activities/entertainment not included above.
71. Required Attachment
73. Attach a street closure map showing the following information:
    1. Street closure location.
    2. Identify what will be used as a moveable barricade(s) and where it will be present on the map.
    3. Identify a 20-foot-wide emergency access lane maintained (equipment utilized during the event can not impede upon emergency vehicle access. Equipment may include tables, chairs, or other party supplies)

75. The map may be a custom Google Map, screenshot of a standard Google Map, other aerial map, or simple sketch, as long as the map highlights the required elements listed above.

76. Upload Street Closure Map*

    Format: Word document or PDF

80. Indemnification/Hold Harmless Agreement

82. I am eighteen years of age or older, fully competent and I desire to host a block party on a non-arterial street in the City of Issaquah. I am fully aware of the fact that there are certain dangers and risks inherent in this activity, including, but not limited to, the risk of serious physical injury, death or other harmful consequences that may arise or result directly or indirectly to me from my event. Being fully informed as to these risks, and in consideration of my being allowed to host the event, I hereby assume all risk of injury, damage and harm to myself and my property arising from my event activities. I also hereby individually and on behalf of my heirs, executors and assigns, release and hold harmless the city of Issaquah, its officials, employees, volunteers and agents and waive any right of recovery that I might have to bring a claim or a lawsuit against them for any personal injury, death or other consequences occurring to me arising out of this event. I agree to abide by any rules, instructions and procedures that city staff provides.

    By signing this Neighborhood Block Party Request form, I agree to defend, indemnify and hold the City, its officers, officials, employees and volunteers harmless from any and all claims, injuries, damages, losses or suits including attorney fees, arising out of or in connection with this event, except for injuries and damages caused by the sole negligence of the City. I agree to abide by any rules, instructions, and procedures that the City staff provides.

84. Signature of Authorized Representative of Sponsoring Event*
85. Date*
    Date
Leave This Blank:


87. 1. Receive an email copy of this form.
88. Email address

    This field is not part of the form submission.

89. Submit

* indicates a required field