Page One

DO NOT ENTER THE PERMIT NUMBER. The authorized official will assign a permit number.

Numbers below refer to the appropriate section of the permit

Section 1. Enter your name or the name of your organization, including the department.

Enter your address or the address of your organization.

Enter your business telephone number and your residence telephone number.

Section 2. Enter the name of the public land that you would like to use for your event or activity and attach a map of the area.  The map should indicate the track or course, concession stand areas, registration area, first aid areas, etc. 

Section 3. Describe the purpose of the event or activity.  State the projected number of participants and spectators.

Section 4. Fill in the arrival date and time and the departure date and time.

Section 5. Check the type of permit you are requesting.  For more information on the different types of permits, go to the Special Recreation Permit page.

Section 6. Describe all facilities that you will be providing, such as porta-potties, concession stands, first aid stations, etc.  Be sure to include all of these facilities on the map. 

Section 7. If you have been issued a permit for a previous event, fill in the name of the BLM office that issued the permit and the date of the permit.  Check whether or not you or your organization forfeited any portion of the permit, bond, or surety or if any investigation or legal action is pending against you or your organization for use of public lands.  If you checked yes, describe the issue in detail on a separate piece of paper and attach it to the application.

Section 8. Sign the application.  If you are filling out the application on-line, print two copies and sign each copy.  Send one original to the appropriate BLM Field Office and keep the other original for your records.  You will not be able to save the information that you entered.

DO NOT CHECK ANY OF THE BOXES ON THIS PAGE.  The authorized official will check the appropriate boxes.

Items a through d are additional information regarding your application. These items must be provided before the application can be approved. Please note item c. A property damage, personal injury, and comprehensive public liability insurance policy is required of all commercial and competitive permitttees and may be required for vending or organized group activities and events. At a minimum, the permittee shall have in force public liability insurance covering: (1) damage to property in the amount of $25,000; and (2) bodily injury or death to persons in the amount of $300,000 per occurrence. The policy shall have a minimum annual aggregate limit of $600,000. The insurance shall also name the United States as additional insured. Check with the appropriate BLM Field Office to determine specific insurance requirements for your proposed activity.

Send your completed and signed application to the appropriate BLM Field Office. Detach page three, the Post Use Report, for filing after the event is completed.

Contact the appropriate BLM Field Office regarding completion of the following information:

• A map of the area, the course or track, and all facilities that you will be providing.
• An operation plan.
• A description of events if you or your organization have, with any previous permits, forfeited any portion of the permit, bond, or surety or if any investigation or legal action is pending against you for use of public lands.
• Proof of private landowner or other agency permission.
• Proof of insurance.
• A copy of your license.
• Any additional district or state forms.

Send this report to the appropriate field office within 30 days of the completion of your event or activity.

• Enter the number of participants, spectators, and employees that attended the event.
• Enter the fees charged to each participant and each spectator.
• Enter the gross profit, and include all receipts.
• Describe any problems that occurred at the event, such as crowd control, hazards, and accidents.
• Write your name, address, and telephone numbers (both business and residence).  Sign the report and send it to the appropriate BLM Field Office.