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3. 
5. Block Host's Name*
7. Block Host's Mailing Address*
9. City*
10. State*
11. Zip*
13. Block Host's Phone Number*
14. Block Host's Email Address*
16. Location of Block Party*
18. Time of Event*
    Time of Event Start Time

    —

    Time of Event End Time
20. Number of Adults Expected to Attend*
21. Number of Children Expected to Attend
23. Traffic Control / Barricades? If needed, please explain.*
25. Would your block party be interested in collecting food donations for a local charity?*

    1. Yes
    2. No
27. If yes to the above question, please let us know if food donations are to be picked up or dropped off

    1. Pick up at Block Party
    2. Drop off at Wayzata Police Department
    3. Not Applicable
29. Comments / Additional Information
31. Data Practices Waiver
    The Minnesota Data Practices Act requires that we inform you of your rights about the private data we are requesting on this form. Under Minn. Stat. § 13.37 (2016), the name, home address, and telephone number you are being asked to provide in this form is private data. However, the location of any National Night Out event is public data. Id. City of Wayzata employees will use any private information you submit contact you in order to organize this event. You are not required by state law or City Code to answer questions or provide the information requested. However, a refusal to answer questions or provide the information requested will prevent you from acting as an organizer for this event.
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33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field