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National Night Out Registration

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CONTACT INFORMATION
Primary Organizer's First Name*
Last Name*
Address*
Phone
Email
Secondary Organizer's First Name
We will use this contact as a backup if unable to reach the primary contact. A secondary contact is not required to participate.
Last Name
Phone
Email
EVENT INFORMATION
Neighborhood/Subdivision
Event Address
Event Type
What style of event are you hosting? (For example, is it a potluck, BBQ, drinks, ice cream social, etc.)
Event Time
Event Time Start Time
—
Event Time End Time
District
Which District is Your Neighborhood In?
Town board members are more likely to stop by the gathering and answer neighborhood questions if/when they know an event is being hosted in their district.
Yes! I want to serve as an event organizer for my community. *
I understand that participation in the National Night Out event is voluntary and that organizers are responsible for planning their event with neighbors and homeowner associations.