WILDERNESS VOLUNTEERS_REDACTED.PDF

Arizona Department of Liquor Licenses and Control DLLC USE ONLY
https://www.azliquor.gov Job #:
(602) S425 41
Date Accepted:
Le:
SPECIAL EVENT LICENSE
License #:
APPLICATION FEE $25.00 PER DAY
MUST be submitted to the Department of Liquor 10 days prior to the event.
SECTION 1
Name of Non-Profit Organization, Candidate or Political Party; Vilderness Volunteers
If the event will be held on an unlicensed premises, it MUST be approved and signed by the Local Governing
Body Before submitting to the Arizona Department of Liquor.
LOCAL GOVERNING BODY
Date Received:
I, OC approval CI pIsAPPROVAL
Government Official Title
On behalf of
City, Town, County Signature Date |
SECTION 2
Will the event be at a location with a current liquor license and within the approved and licensed area?
_lYes [No (if no skip to section 3)
If yes, MUST attach a letter of explanation/permission/suspension from the licensed location and choose ONE option below.
Name of Licensed Location Liquor License Number
[_] Suspend license for the duration of the Special Event; Licensee selling all alcohol without retailer involvement.
Letter of suspension required.
[-] Dispense and serve all spirituous liquors under retailer’s license — Business operates normally, minimum of 25% of
gross revenue from alcohol sales will be donated to licensee. Letter of permission required.
Cc] Dispense and serve all spirituous liquors under special event - The special event licensee is in charge of selling alcohol
that was purchased or donated by the special event licensee. The retailers existing alcohol inventory must be kept
separate from any alcohal used during the special event. Letter of suspension required.
[_] Split premises between special event and licensed location - Both the special event licensee and the licensed
location will conduct sales of alcohol. (These sales must be done in separate areas. If alcohol is donated or purchased
by the special event licensee, it must be in a separate area from the alcohol that is dispensed by the licensed
location.) Letter of explanation and permission required.
[_] Off Sale only - Wine/Distilled Spirits Pull, Live or Silent Auctions — Retailer will be permitted to conduct all normal
sales and service of alcohol. Letter of permission required.
10/28/2025 Page 1 of 4
Individuals requiring ADA accommodations please call (402)542-2999

SECTION 3
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.
Henderson, Carrie J
1. Applicant;
Last First Middle
asec
2. Applicant's mailing
Street City State Zip
928-255-1128
3, Applicants home/cell phone: Non-profit organization phone:
5. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
L]ves (if yes, attach letter of explanation) V1 No
SECTION 4
Wilderness Volunteers
1, Name of non-profit organization:
91-1821692 F08167429
2. Non-Profit/IRS Tax Exempt Number: Arizona Corporation Commission File #:
Required Required
3. If Out Of State, specify State (Attach letter of good standing): N/ A
Pass Mountain Trail Runs
4, Special Event Name:
SECTION 5
Usery Mountain Regional Park
7
3939 N Usery Pass Rd, Mesa, AZ 85207
6, Event Address:
SECTION 6
Must list type of security and control measures will you take to prevent violations of liquor laws at this event.
0 Number of Police 1 Number of Security Personnel WFencing (barriers
}@Nt is surrounded by wind fencing on all sides. One entrance/exit.
Must explain security measures:
Entrance manned by trained staff. No one under the age of 21 is permitted into the service area.
1, 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)
[VJ on-site consumption _Joft-site (auction/wine/distilled spirits pull) [_]Both
7
2. How many special event days have already been issued to this organization during the current year?
10/28/2025 Page 2 of 4
Individuals requiring ADA accommodations please call (602)542-2999

SECTION 7
Dates and Hours of Event - Days must be consecutive and may not exceed 10 days per year.
EVENT START EVENT END
DAYS DATE DAY OF WEEK
TIME AM/PM TIME AM/PM
11/14/2026 Saturday 8:00am 10:00pm
DAY 1
DAY 2
DAY 3
a
RECEIVED
DAY 5
OCT 2 0 2026
DAY 6
MARICOPA COUNTY
DAY 7 CLERK BOARD OF SUPERVISORS
DAY 8
DAY 9
DAY 10
SECTION 8
1, Is the Organization using the services of a DLLC approved Special Event Contractor from the list on our website?
Noah Dougherty (Aravaipa Running,
Wes Ino if yes, please provide the Name of the Special Event Contractor:
Special Event Contractor Signature: Noah Doughuty,
v
2. 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 a special event contractor)
[Wes [VINo if yes, Name of Licensee: Liquor License #:
3, List the name of the Organization/individual that will receive revenues:
MUST EQUAL 100 PERCENT, APPLYING NON-PROFIT MUST RECEIVE A MINIMUM OF 25% OF THE PROCEEDS.
Wilderness Volunteers Percentage: 65
—_—
Street City State Zip
Name; Aravaipa Running, LLC Percentage: 39
2401 S 24th St, Phoenix, AZ 85034
ere
Street City State Zip
Please read A.R.S. § 4-203.02 and R19-1-205 Special event license rules and Requirements.
10/28/2025 Page 3 of 4
Individuals requiring ADA accommodations please call (602)542-2999

SECTION 9
Licensed location 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.
=> ©
ATTACH DIAGRAM
Must attach a diagram of your special event showing the area where alcohol will be sold,
served, and consumed, Must include dimensions of event area, fencing, barricades,
or other control measures, and include positions of security personnel.
NO ALCOHOLIC BEVERAGES SHALL LEAVE A SPECIAL EVENT UNLESS THEY ARE IN SEALED CONTAINERS FOR AN AUCTION OR
WINE/ DISTILLED SPIRITS PULL, OR THE SPECIAL EVENT LICENSE IS STACKED WITH A WINE /CRAFT DISTILLERY FESTIVAL LICENSE.
SSS SSS SST]
Declaration:
|, (Print Name) Carrie Henderson declare under penalty of perjury that | am
,
authorized to submit this application. | have read the contents and to the best of my knowledge believe all statements
made on this application to be true, correct, and complete.
CAM i@ Henderson
Signature:
SPECIAL EVENT DIAGRAM AND
SAFETY PLAN STANDARDS
Diagrams do not need to be overly complicated, they can be hand drawn. However, we
do not accept photographs or aerial views that do not show the premises clearly. The
diagram should clearly depict the special event area in relation to the entire premises.
Each diagram must include:
e Overview of the location
e The event area clearly outlined with black marker
e Where alcohol will be served/stored
e All entrances and exits
e Where security will be positioned
e Square footage of event area
e Show North, East, South, West
10/28/2025 page 4 of 4
Individuals requiring ADA accommodations please call (602)542-2999

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The beer tent is a 20ft x 20ft
tent top with no walls that is
surrounded by wind fencing,
and sectured to the ground | aes 4	1	6	1	2	0	99	2306	1175	142	-1	
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5	1	6	1	2	2	203	2361	160	42	91.295761	T-posts.
5	1	6	1	2	3	374	2359	78	36	96.649025	The
5	1	6	1	2	4	464	2359	156	44	96.696846	fencing
5	1	6	1	2	5	741	2374	9	13	33.665726
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extends an extra 5ft on two of F _
.] the sides making the service y
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area 25ft x 25ft. Thereisone [ig
entrance/exit that is manned
for the entirety of the event.
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3 No alcohol is allowed to leave j@
the fenced-in area. -
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‘i Diagrams are to scale.