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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 - Guiding
   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. Currently, the following guided and/or instructed activities may be permitted by JCOS: Guided Rock/Ice Climbing; Guided River trips including: Rafting, Kayaking, SUP, etc.; Guided Mountain Biking; Commercial Tours; Guided Hiking; Guided Fishing; Guided/Instructional Hang-gliding and para-gliding
8. Contact Information

   Annual permits will be mailed to this address

10. Company/Organization Name
12. Type of Organization
    -- Select One --For-ProfitNon-Profit (501c3)GovernmentOther
13. Please attach your current 501c3 certificate of good standing*
15. First Name
16. Last Name
18. Address
20. Address Line 2
22. City
23. State
24. Zip Code
25. Country
27. Phone Number*
28. Email Address*
30. Permit Type*

    1. Annual - All Parks - Expires Dec. 31
    2. Single Day
31. Permit Delivery*

    Would you like to pick up your permit at the Jefferson County Open Space office, or have it mailed to the above address?

    1. Pick Up
    2. Have Mailed
32. Date and Time*
    Date and Time Start Date

    Date and Time Start Time

    —

    Date and Time End Date

    Date and Time End Time
    For Single Day Only
33. Park Requested*
35. Total Participants (may not exceed 14 for pedestrians or 8 for bikes and horses)*

    Maximum number of clients per occurrence

39. Guided Activities*

    Please select all activities that you would like to guide on JCOS managed land

    1. Rock Climbing
    2. Mountain Biking
    3. Rafting/Kayaking
    4. Fishing
    5. Hiking/Trail Running
    6. Hang/Para-Gliding
    7. Horseback Riding
    8. Other
40. Other

    If other, please explain

41. Number of Vehicles with Logos*
    All vehicles with logos require mirror hang tags, which will be provided
45. Attachments
47. 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 

48. Guide List*

    Please submit a list of all current guides who will be issued permits. If additional guides are added at a later date, please notify JCOS immediately so that we may send additional permits.

49. Year-End Report

    If your organization operated last year, please submit a post-use report of all services rendered on JCOS managed land with total number of clients and revenue. The standardized form can be found on the JCOS Permits page and must be returned as a .xlsx file type.

51. Activity Information*

    A current brochure of your rates or your website that has the current information, such as rates, and trip dates. Please include an itinerary of the specific dates, areas of the park, and number of clients expected.

52. Predicted Use Report*

    Please attach your predicted use report of anticipated dates, parks, and numbers of participants

53. Additional Documentation (if applicable)
57. Returning companies or organizations are required to attach a standard year-end reporting form*

    The standardized year-end reporting form can be found here, under Commercial Activity: https://www.jeffco.us/1512/Permits-Reservations

    1. I have attached the required year-end report to this application
    2. This is my company or organizations first year operating on Jeffco Open Space managed land
59. 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
61. Electronic Signature*
65. 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.
Leave This Blank:


70. 1. Receive an email copy of this form.
71. Email address

    This field is not part of the form submission.

72. Submit

* indicates a required field