Form Center

2. Name
3. Email Address
5. Address
7. City
8. State
9. Zip Code
11. Phone Number
13. Name of park:
15. Purpose of music:
17. Requested date:
19. I hereby certify that:

    1.  the gross revenues from this event shall not exceed twenty-five thousand dollars ($25,000.00) or

    2. that I have obtained the necessary licensing for broadcasting copywritten content

    I agreed to defend and hold the City, its elected officials, employees, agents and representatives harmless against any claim of copywrite infringement or unauthorized use. 

21. Electronic Signature
23. Date
Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field