National Night Out Registration Form

Print
Press Enter to show all options, press Tab go to next option
Please correct the field(s) marked in red below:

Coordinator Information

Coordinator Information

Neighborhood Watch Group Information

Neighborhood Watch Group Information

Is this your neighborhood's first time participating in National Night Out?

Is this your neighborhood's first time participating in National Night Out?

Council Member District (Choose One)

Council Member District (Choose One)

Block Party Information

Block Party Information

Participation

Participation

Street Closure?

NOTE: If you are closing the street for your block party, please complete a block party permit application and submit it to the City Clerk’s Office (900 E. Strawbridge Avenue Melbourne, FL 32901, or  city.clerk@mlbfl.org) no later than July 6, 2019. 

Street Closure? NOTE: If you are closing the street for your block party, please complete a block party permit application and submit it to the City Clerk’s Office (900 E. Strawbridge Avenue Melbourne, FL 32901, or city.clerk@mlbfl.org) no later than July 6, 2019.

Block Party Theme

Block Party Theme
  1. To receive a copy of your submission, please fill out your email address below and submit.
    CAPTCHA
    Change the CAPTCHA codeSpeak the CAPTCHA code