Please consider the following prior to submitting this application:
We do not permit amplified sound, structures, decorations or athletic/party games.
Please read all of the park regulations before submitting this application.
In order to ensure sufficient time to process your permit, please submit this form no less than five business days prior to your event. Applications will not be reviewed outside of six (6) months in advance. Rental time is limited to a five-hour block from 10 a.m. to 7 p.m., April through September; and 10 a.m. to 5 p.m., October through March.
Please also read the information contained within this web page on the fees, insurance and conditions associated with a park permit agreement before filling out and signing this form.
The responsible person/organization holding the activity will submit a certificate of insurance showing Jefferson County as the certificate holder and additional insured on all liability policies. Insurance minimum will be one million per occurrence, one million aggregate. Auto liability and workers' compensation coverage (with statutory limits) may be required.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
I (we) hereby swear or affirm, under penalty of perjury, that the information given here is true and correct. The typed signature below indicates this individual, or the legal entity the individual represents (as applicable), accepts responsibility for the activity and agrees to the terms and conditions of this agreement.
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