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2. Organization Name*
4. Event Name*
6. Event Date*
   Event Date
7. Event Start Time*
   Event Start Time
8. Event End Time*
   Event End Time
10. Contact Person Name*
12. Contact Person Email Address*
14. Contact Person Phone Number*
16. Short Description of Event*
18. Age Group of Participants*
20. Total Number of Participants*

    These numbers are being requested if the Fire Department decides to bring handouts for the kids.

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22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

* indicates a required field