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Request for Special Event Coverage

This form must be completed in full at least 4 weeks before the event for consideration.

After receiving your request for Special Event Coverage Form ,Durham County EMS will determine if coverage will be offered.

  • If coverage is offered, Durham County EMS will decide which EMS resources(s) will be used and we will provided a confirmation and an estimated cost.
  • Factors used to determine whether/how coverage will be offered may include: event crowd size (2,500+), risk factors for participating population, EMS access to venue (area traffic impedance), EMS availability and event impact on 9-1-1 operations.
  • If you do not hear from in us within one (1) week of your initial request, contact us at 919-560-8212.
  • This is the DCoEMS_Request for Special Event Coverage.


Please correct the field(s) marked in red below:

View current coverage options and costs or print out paper copy of request to scan and email at dcemsevents@dconc.gov.

SUBMITTER INFORMATION

1
 Please fill out the following information.
 *
Please fill out the following information.
2
Type of Event to be Covered:
Type of Event to be Covered:
3
 Anticipated Crowd Size (including staff/volunteers/attendees)
Anticipated Crowd Size (including staff/volunteers/attendees)
Crowd Size
<2,500
2,500 - 15,000
15,000 - 50,000
> 50,000
4
Please provide the following information:
 *
Please provide the following information:
5
Please provide us with the following information:
 *
Please provide us with the following information:
6
Will food and beverage be sold at the event?
Will food and beverage be sold at the event?
7
Will alcoholic beverages be sold at the event?
Will alcoholic beverages be sold at the event?
8
Please provide us with billing information for the event.
 *
Please provide us with billing information for the event.
9
Please let us know if we need to know any additonal inofrmation about your event that you feel is important we know about.
  1. To receive a copy of your submission, please fill out your email address below and submit.

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