2021 Geary County Event Planning Form
Geary County Health Department
Name of the Event
Point of Contact
First Name
Last Name
Phone Number
Email
Estimated number of total participants in the event
Estimated number of total participants per hour
Date of Event
-
Month
-
Day
Year
Date
Start Time
Hour Minutes
AM
PM
AM/PM Option
End Time
Hour Minutes
AM
PM
AM/PM Option
Address of Event
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Type of Location
Indoor
Outdoor
Both
Will food be served at the event?
Yes
No
Will beverages be served at the event?
Yes
No
Are masks mandatory at the event?
Yes
No
Will hand sanitizer or hand washing stations be available at the event?
Yes
No
Please describe the event
What type of infection control processes are being implemented for this event?
Submit
Should be Empty: