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Yates County Public Health Large Gathering/Event or In- person Catered Event Notification Form

  1. Note: This form only needs to be completed for indoor events over 250 people or outdoor events over 500 people
  2. EVENT INFORMATION
  3. Include time for setup (unloading, etc)
  4. Include time for cleanup (loading, etc)
  5. Location on Premises*
  6. Please provide additional details, if needed
  7. Attestation
    I am the Responsible Party for the event listed. I have reviewed all applicable New York State interim guidance for event activities and operations during the COVID 19 public health emergency, and I affirm that I have read and understand my obligation to operate this event in accordance with such guidance. I understand the event may be subject to inspection by Yates County Public Health to ensure compliance with all provisions of the guidance.
  8. Attestation sign off
  9. Leave This Blank:

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