Outdoor Program Application

Request Type (required):

Organization Information

Company/Organization Name (required)

Tax Status (required):

Agency EIN/Tax ID

Web Address

Organization Address (required)

Organization Address 2

Organization City (required)

Organization State (required)

Organization ZIP/Postal Code (required)

Mailing Address, if different

Mailing City, if different

Mailing State, if different

Mailing ZIP/Postal Code

Description of Program/Organization

Primary Contact Info

First (required)

Last (required)

Date of Birth (required)

Email Address (required)

Phone (required)

Requested Locations

Name of Event

Roaming (25 or less)

*Groups of 25 or less may request to be “roaming” if a designated picnic area is not needed. Groups are not allowed to use any of the reservable locations and would need to use the first-come, first-serve tables.

Reservable

1st Choice

Park:

Reservable Site:

2nd Choice

Park:

Reservable Site:

3rd Choice

Park:

Reservable Site:

Request Details

Start Date:

End Date:

Hours of event:

Arrival/Setup:

Event Start

Event End

Cleanup/Departure

Age Group of Attendees:

Pre-School

Elementary

Middle School

High School

Adult

Senior

Estimated Attendance (Staff, volunteers and spectators; including children and adults):

Staff/Crew:

Participants:

Spectators:

Please list any excluded dates, such as holidays in which you will not be holding camp

Daily Activities; please provide the details of your event, or include an attachment below:

NOTE: must include written/detailed schedule.

Please type your emergency response plan, including your lost child protocol:

ALL Emergency plans must be specific to park location and include the following: Program staff must contact EBRPD Dispatch first in the event of ANY moderate/severe injuries or medical incidents. For emergencies, 510-881-1121. For non-emergencies, 510-881-1833.

ATTACHMENT SUPPLEMENTAL DOCUMENT

Only one file can be submitted, you may combine any supplemental information in one document to attach. This would include a map of the areas you are planning to use (for pick-up/drop-off, parking, activities, etc.), information about daily activities, a schedule of events, etc.

Every attempt will be made to accommodate your first choice. Some locations are impacted and may not be accepting applications. If requesting more than one park, please use a separate application for each.

*This is an inquiry form ONLY, and if approved to start the permit process, an application packet will be provided. NO advertising until an approved permit is on-file. You should receive a response to your inquiry within 7-10 business days. Questions? Email respermit@ebparks.org. Thank you.

One file only.
100 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, avi, mov, mp3, mp4, ogg, wav, svg, zip.

Outdoor Program Application

Organization Information

Primary Contact Info

Requested Locations

Request Details

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