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Block Party Application

  1. Is this a new or returning block party?*

  2. Please provide the names and addresses of 2 neighbours who support the block party and consent to being alternate block party contacts.

  3. Will there be outdoor amplified sound? For example, music played through speakers.

    Note: Any amplified outdoor sound must end by 10 pm.

  4. Do you want to have fireworks at your block party?

  5. Road Closure Request

    A road closure is required for any block party that takes place on a City of Coquitlam road including cul-de-sacs, lanes and widened road areas.

  6. Will your block party require road closures?*

  7. Block Party Play Kit

  8. Would your block party like to reserve and borrow a Block Party Play Kit? The play kit is a sports bag filled with balls, frisbees, cones, pylons and more. Block Party Play Kits are reserved on a first come, first served basis.

  9. Block Party Grant Request

  10. Will your block party be applying for the $150.00 Block Party Grant?*

  11. Collection & Use of Personal Information*

    By checking "I consent" you are consenting to the voluntarily collection and use of your personal information in accordance with Section 26(d) of the Freedom of Information and Protection of Privacy Act. The information provided by you will be used solely for the purpose of registering for Block Parties. Your information will not be used for any other purpose. If you have any questions about the collection, storage, correction and/or use of your personal information please contact Karen Basi - City of Coquitlam Cultural Services Manager at 604-927-3599.

  12. Leave This Blank:

  13. This field is not part of the form submission.