SOUTHWEST WILDLIFE CONSERVATION CENTER_REDACTED.PDF

Amada t #10

CSR:
Amount:
DLLC USE ONLY
Job #:
SPECIAL EVENT LICENSE cre
APPLICATION FEE $25.00 PER DAY
CSR:
Arizona Department of Liquor Licenses and Control .
800 W. Washington St. 5" Floor Phoenix, AZ 85007 Ucenze #:
(602) 542-5141

Application MUST be submitted to the Department of Liquor 10 days prior to the event.

SECTION 1 Applicant must be a member of a qualifying nonprofit organization, political party, or Government entity and
authorized by an Officer, Director, or Chairperson of the Organization.

1. Applicant: Wilson Robin Christine
(Must be an Officer/Member of the No!

2. Applicant's mailing address:

Tip

ole
3. Applicants home/cell phone! Applicant's business phone: 602-677-1076

@ Applicants emat odes: Pe

5. Special Event Name: Adrenaline Night Runs

6. Name of Non-Profit Organization, Candidate or Political Party/Gov: Southwest Wildlife Conservation Center

7. Non-Profit/IRS Tax Exempt Number: 86-0765249

8. Arizona Corporation Commission File #: 07187250 If out of State please specify:

(Attach letter of good standing)
9. Event Location Name: McDowell Mountain Regional Park

(rovent Address: 16300 McDowell Mountain Park Drive, Fé
4

3 Fort McDowell, Arizona 85264

Dates and Hours of Event - Days must be consecutive and may not exceed 10 consecutive days.

“*SEPARATE APPLICATION FOR EACH “NON-CONSECUTIVE” DAY**

. Event Start license End
Days Date Day of Week Time AM/PM Time AM/PM

DAY 1: 5.20.23 Saturday 6PM 2AM

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DAY 2: oe
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DAY 3:

DAY 4:

DAY 5:

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DAY 6:

DAY 7:

DAY 8:

DAY 9:

DAY10:

11/7/2022 Page 1 of 3
Individuals requiring ADA accommodations please call (602)542-2999

CSR:
Amount:

DLLC USE ONLY
Job #:

SPECIAL EVENT LICENSE

Date Accepted:

APPLICATION FEE $25.00 PER DAY

CSR:

Arizona Department of Liquor Licenses and Control
800 W. Washington St. 5" Floor Phoenix, AZ 85007 Ucense:t:

(602) 542-5141
Application MUST be submitted to the Department of Liquor 10 days prior to the event.

SECTION 1 Applicant must be a member of a qualifying nonprofit organization, political party, or Government entity and
authorized by an Officer, Director, or Chairperson of the Organization.

1. Applicant; Wilson Robin Christine
(Must be an Officer/Member of the No!
2. Applicant's mailing ccs: limite
Clty Slate Up
3. Applicants home/cell — 2 Applicant's business phone: 602-677-1076
4. Applicant's email ccc

5. Special Event Name; Adrenaline Night Runs

6. Name of Non-Profit Organization, Candidate or Political Parly/Gov; Southwest Wildlife Conservation Center

7. Non-Profit/IRS Tax Exempt Number; 86-0765249

8. Arizona Corporation Commission File #: 07187250 If out of State please specify:

(Atiach letter of good standing)
9. Event Location Name; McDowell Mountain Regional Park

10. Event Address: 16300 McDowell Mountain Park Drive, Fountain Hills, Arizona 85268

Dates and Hours of Event - Days must be consecutive and may not exceed 10 consecutive days.

**SEPARATE APPLICATION FOR EACH “NON-CONSECUTIVE” DAY**

Days Dae pay.chWeek aes Eber
wart . 5.20.23 Saturday 6PM 2AM =
DAY 2: = z —
DAY 3: Ay
DAY 4: 2
DAY 5: is
DAY 6: o
DAY 7:
DAY 8:
DAY 9:
DAY10:

11/7/2022 Page 1 of 3

Individuals requiring ADA accommodations please call (602)542-2999

SECTION 2 What type of security and control measures will you take to prevent violations of liquor laws at this event?
(List type and number of police/security personnel and type of fencing or conirol barriers, if applicable.)

Number of Police 1 Number of Security Personnel [Fencing CBaniers

Must explain security measures: ID check and wristbands to those 21 years of age and older. Security

personnel will remain at the entrance/exit of the fenced in beer garden for the duration

of the event to ensure no alcohol leaves the designated beer garden.

SECTION 3 Whatis the purpose of this event?
[4lon-site consumption [off-site (auction/wine/distilled spirits pull) [Both

How is this special event going to conduct all dispensing, serving, and selling of spirituous liquors?
Check one of the following boxes. (R-19-318)

A) [4] Special Event being held on an unlicensed premises will require approval and signature by the Local Governing
Body on page 3. {If checked move to section 4)

B) [1] Wil this event be held ona currenily licensed premises and within the already approved and licensed area?
(Must aitach a letter from the licensed premises with an explanation of the option checked below)

Name of Business Ulcense Number Phone (Include Area Code)

[Place license in non-use - Special Event Licensee selling all alcohol without retailer involvement
Must attach letter from the location suspending license for duration of special event

Lbispense and serve all spirituous liquors under retailer's license — Business operates normally, minimum of 25% of gross
revenue from alcohol sales is donated to licensee

Ldispense and serve alll spirituous liquors under special event - The special event licensee is in charge of selling alcoho! that
was purchased or donated by the special event licensee. The retailers existing alcohol inventory must be separated from any
alcohol used during the special event. Must attach letter from the location suspending license for duration of special event

Cspiit premise between special event and retail location - Both the special event licensee and the retailer will conduct
sales of alcohol. (These sales will be done in separate areas. If alcohol is donated or purchased by the special event licensee
it must be in a separate area than the alcohol that is dispensed by the licensed retailer.)

Loft sale only - Wine/Distilled Spirits Pull, Live or Silent Auctions — Retailer will still be permitted to conduct all normal sale
and service of alcohol.

SECTION 4

1. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
LD Yes No If yes, attach letter of explanation.

2. How many special event days have been issued to this organization during the calendar year? 5

3. Is the Organization using the services of a Special Event Contractor? (A licensee can utilize the services of a special
event contractor who may purchase and sell alcohol on behalf of the licensee. If no special event contractor is listed, the
licensee is responsible for the sales and service of alcohol. }

Aravaipa Running, Noah Doughert!
[]Yes CINo ff yes, please provide the Name of the Special Event Contractor: P g ghenly

4. Is the organization using the services of a series 6, 7, 11, or 12 licensee to manage the sale or service of alcohol?
(Licensees who hold a series 6, 7, 11, or 12 license are automatically qualified to be the special event contractor)

C1 Yes [¥] No if yes, please provide the Name of Licensee: License #:

11/7/2022 Page 2 of 3
Individuals requiring ADA accommodations please call {602)542-2999

5. List the name of the Individual or Organization that will receive revenues, MUST EQUAL 100 PERCENT.
Attach additional sheet if necessary.

Name: Southwest Wildlife Conservation Center Percentage: 65
Address: 0 11 E Pinnacle Peak Rd PMB 115, Scottsdale, Arizona 85255
Name: Aravaipa Running, LLC _ Percentage: 36 .
Addrass: 2401 S 24th St PReSh. Arizona 85034 2
Sieal Gily Siale ip

Please read A.R.S. § 4-203.02 Special event license; rules and R19-1-205 Requirements for a Special Event License.
ALL ALCOHOLIC BEVERAGE SALES MUST BE FOR CONSUMPTION AT THE EVENT SITE ONLY.

SECTION 5 License premises diagram. The licensed premises for your special event is the area in which you are
authorized to sell, dispense or serve alcoholic beverages under the provisions of your license. Please attach a diagram
of your special event licensed premises. Please show dimensions, serving areas, fencing, barricades, or other control
measures and security position.

If the special event will be held at a location without a permanent liquor license or if the event will be on any portion of a location
that is not covered by the existing liquor license, this application must be approved by the local governing body before submilling
to the Department of Liquor Licenses and Control. Please contact the local governing board for additional information.

APPLICANT SIGNATURE

Declaration: . sags .
|, (Print Name) Robin Christine Wilson , declare under penalty of perjury that | am

I authorized to submit this application. | have read the contents of this application, and to the best of my knowledge
believe all statements made on this application to be true, correct a Cor

\

Soe

LOCAL GOVERNING BODY

Date Received:

I, recommend LIJAPPROVAL [J DISAPPROVAL
(Government Official) {Tille)

On behalf of

(City, Town, County) Signature

AZDLLC USE ONLY

CIAPPROVAL LI DISAPPROVAL BY:

11/7/2022 Page 3 of 3
Individuals requiting ADA accommodations please call (602)542-2999

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