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JCOS - 2023 Special Activity Application

  1. Disclaimer
    Information submitted on this form will be sent via unsecured email. To protect sensitive information, do not enter the following items or similar information on this form: Social Security numbers, driver’s license numbers, bank account information, routing numbers, credit card numbers, medical information, passport numbers, and passwords. Please review our privacy policy located at www.jeffco.us/privacy. By submitting this form, you acknowledge and accept the terms listed in the privacy policy.
  2. All Special Activity applications for events to be held in the 2023 calendar year are due no later than October 8, 2022 at 11:59pm and responses to applicants will be issued no later than December 1, 2022. Please also read the information contained within the Permits and Reservations web page regarding fees, insurance and conditions associated with a park permit agreement before submitting this form.
  3. Please be as thorough as possible
  4. Mission available here: https://www.jeffco.us/1571/About-Us
  5. Contact Info. of Event Organizer
  6. Contact Info. of Responsible Person on Site During Event
  7. If non-profit, please enter your state issued EIN or Registration ID and attach a copy of your state issued Certificate of Good Standing in the next field

  8. If you are applying as a non-profit, a current certificate of good standing must be attached. Failure to attach this document will result in an incomplete application and will be discarded. 

  9. Documentation

    All applicants are required to submit an event plan including: detailed description of event, course or event map, parking management plan, emergency management plan, and site plan (e.g., locations of staging, canopies, etc., as applicable). Please submit these as a single .pdf document. Additionally, please attach a copy of your Certificate of Insurance. 

  10. As needed

  11. Please verify that you have included the required items*
  12. Electronic Signature Agreement*
    I understand that I am responsible and accountable for all aspects of this event including, but not limited to: all agreed upon Terms and Conditions of approved permit, damage to trails, damage to facilities, ensuring that all participants abide by all JCOS Park Regulations outside of those which are specifically addressed in issued permit, and cancelation of event if adverse conditions are present.
  13. 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.
  14. Receive a Copy of Your Submission
    By checking the box below, you will receive a copy of the application you are submitting; however, this does not mean that your application has been approved. We will contact you no later than December 1st, 2020 to let you know the status of your application.
  15. Leave This Blank:

  16. This field is not part of the form submission.