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2. Frederick Alcohol Permit Application
4. Name Of Applicant
5. Date Submitted
6. Phone Number
8. Address
9. City
10. State
12. Zip
13. Date of Birth
14. Type of Activity
15. Date of Use
17. Number of People Attending
18. Name of the park (Crist Park or Frederick Recreation Area)
20. Group/Organization Name

    Commercial Entities - See Insurance Requirements

21. Alcohol may only be consumed on park property between sunrise and sunset.

23. ONLY WINE AND BEER ALLOWED*

    1. WINE AND BEER ONLY

    I ACKNOWLEDGE BY CHECKING THE BOX THAT I UNDERSTAND ONLY WINE AND BEER IS ALLOWED FOR THIS EVENT.

25. Consumption Start
26. Consumption End
27. Age Range of Guests
29. ENTERTAINMENT PROVIDED:

    1. Yes
    2. No
30. Describe Entertainment:
32. Food Provided:

    1. Yes
    2. No
33. Describe Provided Food:
35. PLEASE ATTACH A DIAGRAM DEPICTING THE AREA WHERE WINE AND/OR BEER WILL BE CONSUMED.

    Wine and beer can only be served/consumed in a roped off and posted area, segregated from the general public.

36. Alcohol needs to be kept separate from other beverages.
38. How do you plan to secure the area and inform guests that alcohol consumption must be kept in a designated area?
39. How will you supervise the participants during the function?
41. If minors will be attending, how do you plan to make sure they do not obtain or consume alcoholic beverages?
42. Will you be checking I.D.’s if you are not sure of someone’s age?

    First Last (Age), First Last (Age)

44. How will you keep alcohol from those persons under the influence of alcohol?
45. List names and ages of all individuals who will help supervise the function:
47. APPLICABLE EXCERPTS FROM COLORADO REVISED STATUES
    
    

    Alcoholic Beverages

    Colorado Revised Statutes section 44-3-901. Unlawful acts – exceptions – definitions.

    (1) Except as provided in section 18-13-122, it is unlawful for any person:

    (a) To sell, serve, give away, dispose of, exchange, or deliver, or permit the sale, serving, giving, or procuring of, any alcohol beverage to a visibly intoxicated person or to a known habitual drunkard;

    (b)

    (I) To sell, serve, give away, dispose of, exchange, or deliver or permit the sale, serving, giving, or procuring of any alcohol beverage to or for any person under the age of twenty-one years.

    . . .

    (d) To possess alcohol beverages in any store, in any public place, including public streets, alleys, roads, or highways, or upon property owned by the state of Colorado or any subdivision thereof, or inside vehicles while upon the public streets, alleys, roads, or highways when a person is under twenty-one years of age;

    (e) To knowingly, or under conditions that an average parent or guardian should have knowledge of, suffer or permit any person under twenty-one years of age, of whom such person may be a parent or guardian, to violate the provisions of subsection (1)(c) or (1)(d) of this section;

49. INSURANCE REQUIREMENTS

    COMMERCIAL ENTITIES SHALL BE REQUIRED TO PROVIDE A CERTIFICATE OF INSURANCE EVIDENCING LIABILITY COVERAGE. ADDITIONALLY, THE CERTIFICATE SHALL NAME THE TOWN OF FREDERICK AS AN ADDITIONAL INSURED FOR THE SUBJECT EVENT. THE TOWN ADMINISTRATOR WILL NEED TO APPROVE THIS CERTIFICATE.

51. By Checking This Box I Certify:*

    1. I AGREE

    I am 21 years of age or older and the information I have provided herein is true and correct to the best of my knowledge. I hereby apply for a permit to consume alcohol on Town property as indicated on this application form. I will be present for the duration of the function and understand and agree to the following:

    
    1. I will be responsible for proper traffic control and maintaining order at the event.
    2. I will control the consumption of alcohol in compliance with Town and State regulations
    3. I will check I.D.’s of anyone whose age is not know and not allow minors to consume alcohol.
    4. I will not allow alcoholic beverages to be consumed in glass containers.

    
    I/we release the Town of Frederick from and agree to save and hold harmless, defend and indemnify the Town of Frederick from all claims and damages or liability of any kind that may result from my/our performance of services or use or occupation of the park facility and/or shelter, including claims alleging negligence or other wrongful acts or omissions of the Town. I/we agree that neither the Town of Frederick, nor any of its officers, agents, volunteers, assistants, or employees shall be held responsible or made subject to any claims, including any claim for negligence, seeking to assess damages or liability for or arising from personal injury or property damage to self or others in attendance during the use of the park facility and/or shelter. I/we release and agree to save and hold the Town of Frederick harmless for any claims for damages to myself resulting from suspension, revocation or modification of the permit.

53. Applicants (1) Signature:*
54. Applicants (2) Signature:
55. Date
Leave This Blank:


57. 1. Receive an email copy of this form.
58. Email address

    This field is not part of the form submission.

59. Submit

* indicates a required field