In-Person and Catered Event Registration Form

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Please complete all fields on this form to register your catered event that involves the gathering of attendees above the State’s social gathering limit, and that may feature food and beverage service, as described in the "INTERIM GUIDANCE FOR FOOD SERVICES DURING THE COVID-19 PUBLIC HEALTH EMERGENCY" page on the NYS WEBSITE:

https://www.governor.ny.gov/sites/governor.ny.gov/files/atoms/files/Indoor_and_Outdoor_Food_Services_Detailed_Guidelines.pdf

*Effective May 19, 2021, the additional requirements apply to all indoor in-person and catered events in a residential setting with 51 or more attendees, and indoor events in a non-residential setting with 251 or more attendees, exclusive of employees and event staff. Effective May 19, 2021, the additional requirements apply to all outdoor in-person and catered events in a residential or non-residential setting with 500 or more attendees, exclusive of employees and event staff.

Notification to Suffolk County of qualifying events must be made at least 5 days prior to the event. A separate form must be completed for EACH event.

Any questions? Email php@suffolkcountyny.gov or call to 311 for details.

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Venue Name or Event Location: *

Responsible Party name: *

Responsible Party Street Address: *

Responsible Party Town: *

Responsible Party Zip: *

Responsible Party Phone: *

Responsible Party Email: *

Event or Function Name: *

i.e., “Smith Wedding”

Event Street Address: *

Event Town: *

Event Zip: *

Event Date *

JJJJ

Event Start Time: *

Zeit

Event End Time *

Zeit

Event Setup/Unloading Start Time: *

Zeit

Event Breakdown/Loading End Time: *

Zeit

Expected Number of Event Attendees: *

Must be within guidance specifications

Expected Number of Event Staff: *

Location of Event on Premises: *

i.e., “Blue Room”, “Rear Patio”

I have read and understand my obligation to operate in accordance with the New York State Guidance for Food Services, and have submitted affirmation of same to New York State. *

If not already completed, affirmation can be made through a link at the bottom of the Food Services Guidance document (Linked above)

Yes

Events may be subject to inspection by Suffolk County authorities to ensure compliance with all provisions of the guidance.

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