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2. 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.
4. Commercial Activity Application - Other

   Permitted activities must be appropriate to the mission of Jeffco Open Space; complement resource protection, visitor protection and interpretation goals; and not pose any potential for derogation of values or purposes for which JCOS was established.

6. In order to ensure sufficient time to process your permit, this form must be submitted no less than ten business days prior and no more than six month in advance of your requested date. 

8. This form is intended for those who wish to conduct commercial filming, student filming projects, and commercial photography outside of small scale portrait photography (small scale portrait photography shoots may obtain a portrait photography permit). 

   Cost recovery fee for commercial filming - $250 per day.

   Please note that the use of drones for the purpose of filming is prohibited and will not be exempt with issuance of a park permit.

10. Company/Organization Name*
12. Company/Organization Website
14. Contact Information
16. First Name*
17. Last Name*
19. Address*
21. Address Line 2
23. City*
24. State*
25. Zip Code*
26. Country*
28. Phone Number*
29. Email Address*
31. Name of Client (if applicable)
33. Park(s) Requested*

    Please verify that your requested site is managed by Jefferson County Open Space before submitting

34. Specific Area of Park*
35. Date and Time*
    Date and Time Start Date

    Date and Time Start Time

    —

    Date and Time End Date

    Date and Time End Time
36. Total number of people involved*

    Please note that the maximum number of people which may be permitted is 14

40. Please describe the scope and theme of your project in detail*

    If you are requesting multiple dates or date ranges, please reflect those here

42. Where will this footage be used or publicized?*
46. Attachments
48. Please upload your Certificate of Insurance*

    Please upload your Certificate of Insurance. Jefferson County must be added as an additional insured to general liability policies. Certificate Holder must be:

    Jefferson County, Colorado
    c/o IMA Certificate Compliance
    1705 17th Street, Suite 200
    Denver, CO 80202 

49. Story Board of Shoot*
50. Additional Documentation (if applicable)
54. Terms and Conditions*

    By submitting this application, you agree to abide by all Jefferson County Open Space Park Regulations and, if approved, all Terms and Conditions listed in your Park Permit. 

    1. I agree.
56. Electronic Signature Agreement*

    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.

    1. I agree to the terms and conditions
58. Electronic Signature*
62. 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 within 10 business days to let you know the status of your application.
68. Non Refundable Application Fee
    Non Refundable Application Fee
69. Price
70. Quantity
71. Shipping Cost
73. Taxable
Leave This Blank:


74. Calculate Totals Proceed to Checkout

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