2. To hold an event in a Roanoke County park space or picnic shelter, this special use application must be completed and approved by our staff. Depending on the nature of the event, you may be required to obtain an assembly permit from the Roanoke County Police Department.

   Special use applications may be submitted up to 6 months in advance of your event. Submissions received within 14 business days of your event may not be considered. If approved, a permit will be issued. 

   Once this form is submitted, please allow 48 hours for our Customer Service Staff to contact you regarding the application.

4. NOTE: SUBMISSION OF THIS APPLICATION DOES NOT CONSTITUTE APPROVAL
6. Primary Event Contact*
7. Organization Name (if applicable)
9. Contact Primary Phone*
10. Contact Email*
12. Primary Contact Date of Birth (MM/DD/YYYY)*
14. Street Address*
15. City*
16. State*
17. Zip Code*
19. Event Type (Please Select All Applicable)*
    -- Select One --Picnic Shelter RentalPrivate EventCommunity EventAthletic / Sport EventRaceProgram / Class / CampVolunteer / CleanupOther
20. If "other" event type, please describe:
22. Event Purpose*

    Please describe the purpose of the event, e.g., birthday party, bridal shower, etc.

24. Name of Park or Facility Requested*
25. Attendance Expected*
27. Which park amenities are you requesting?*

    1. Picnic shelter
    2. Ball fields

    1. Parking lots
    2. General Park Open Space
29. Event START Date and Time*
    Event START Date and Time

    Event START Date and Time
30. Event END Date and Time*
    Event END Date and Time

    Event END Date and Time
32. Do you plan to charge any attendance or registration fees?*

    1. Yes
    2. No
33. If yes, what is the fee amount per participant?
35. If your event requires setup/cleanup time outside the hours listed above, please specify here:
37. Description of this event:*
39. Upload additional information here such as schedules, race maps:
40. Upload additional information here such as schedules, race maps:
41. Upload additional information here such as schedules, race maps:
43. Roanoke County requires pre-approval for any special amusements, games or special activities such as amusement rides, moon bounces, dunking booths, petting zoos, tents etc. to be set up on County property. Additionally, events with over 100 participants will be required to obtain a certificate of insurance.The addition of these special activities will require the event to provide a $1 million liability insurance certificate with the Roanoke County Board of Supervisors Named as the Additional Insured.
45. Does your event require pre-approved amusements?*

    1. Yes
    2. No
46. UPLOAD CERTIFICATE OF INSURANCE: If not attached with your application, the certificate must be received within 10 days of your application approval or you will forfeit your reservation.

    Roanoke County Boards of Supervisors at 5204 Bernard Drive, Roanoke, VA 24018 need to be listed as additionally insured with a $1,000,000 General Liability minimum.

48. Do you require water or electricity? Check all that apply:

    1. Water
    2. Electricity
49. NOTE: Most sites do not have water or electricity and are not guaranteed. Please review site amenities at www.RoanokeCountyParks.com
51. Do you plan to serve alcohol at your event?*

    1. Yes
    2. No
52. NOTE: Alcohol permits are available ONLY for Green Hill Park, Explore Park and Camp Roanoke. By checking YES, our special events staff has been notified and will contact you.

    You are responsible for obtaining:

    • Roanoke County Alcohol Permit - approval required before submitting for an ABC permit
    • Virginia ABC Permit
54. How many portable toilets are needed?

    Regular event toilets will be charged at a rate of $65/toilet. ADA toilets are $90/toilet. Handwashing stations are $65/each.

    *Toilets and stations may be added at the discretion of county staff based on event size and location.

56. Please describe any additional requested maintenance support:

    *It is at the discretion of Roanoke County staff to determine if a Parks staff member is needed, based on the size and structure of your event. If necessary, you will be billed at a rate of $35/hr.

58. Will someone other than the primary event contact be on site for the event?

    1. Yes
    2. No
60. Day of Event Staff Name
61. Day of Event Staff Cell Phone
62. Day of Event Staff Email
64. Complete your application by clicking SUBMIT below. Our staff will respond within 14 business days after reviewing your request. Questions? Call our administrative office at (540) 387-6078 ext. 0.
Leave This Blank:


65. 1. Receive an email copy of this form.
66. Email address

    This field is not part of the form submission.

67. Submit Submit and Print

* indicates a required field