WILDERNESS VOLUNTEERS_REDACTED.PDF
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Arizona Department of Liquor Licenses and Control DLLC USE ONLY https://www.azliquor.gov Job #: (e02) iiiediaaain Date Accepted: Le: SPECIAL EVENT LICENSE APPLICATION FEE $25.00 PER DAY License #: 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: Wilderness 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: C1 approval C1 pisAPPROVAL Government Official Title On behalf of City, Town, County Signature SECTION 2 Will the event be at a location with a current liquor license and within the approved and licensed area? Llves VINo If yes, MUST attach a letter of explanation/permission 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. CJ 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. O 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 alcohol used during the special event. O 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.) | Off Sale only - Wine/Distilled Spirits Pull, Live or Silent Auctions — Retailer will be permitted to conduct all normal sales and service of alcohol. 5/5/2025 Page 1 of 3 Individuals requiring ADA accommodations please call (602)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. 1. Applicant: Henderson, Carrie J. Last Middle 2. Applicant’s mailing addres: City State Zip 3. Applicants home/cell phone} Non-profit organization phone: 928-255-1128 5. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years? [yes (if yes, attach letter of explanation) VW] No 6. Name of non-profit organization: Wilderness Volunteers 7. Non-Profit/IRS Tax Exempt Number: 91-1821692 Arizona Corporation Commission File #: F08167429 Required Required 8. If Out Of State, specify State (Attach letter of good standing): 9. Special Event Name; McDowell Mountain Frenzy 10. Event Location Name: McDowell Mountain Regional Park 11. Event Address: 16300 McDowell Mountain Park Dr, Fort Mcdowell, AZ 85264 SECTION 4 Must list type of security and control measures will you take to prevent violations of liquor laws at this event. Number of Police 4 Number of Security Personnel [V]Fencing Lbarriers Must explain security measures: The beer garden will be surrounded by wind fencing on all sides with one entrance The entrance/exit will be monitored by a staff member for the duration of the event. Only patrons above the age of 21 will be permitted to enter. 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) [Vlon-site consu mption Llott-site (auction/wine/distilled spirits pull) Ceoth 2. How many special event days have already been issued to this organization during the current year? 6 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. 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 positions of security personnel. ==> ATTACH DIAGRAM 4a 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. 5/5/2025 Page 2 of 3 Individuals requiring ADA accommodations please call (602)542-2999 SECTION 5 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 DAY 1 12/6/2025 Saturday 8:00am 11:00pm DAY 2 DAY 3 DAY 4 RECEIVE! ) — DAY5 DAY 6 02025 DAY7 CLE MARICOPA COUNTY ~ ERVISORS DAY 8 DAY 9 DAY 10 SECTION 6 3. Is the Organization using the services of a DLLC approved Special Event Contractor from the list on our website? Wes [no If yes, please provide the Name of the Special Event Contractor: Aravaipa Running LLC Special Event Contractor Signature: 7#a10 Garber 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 a special event contractor) [Ves [VINo if yes, Name of Licensee: Liquor License #: 1. 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. 2. Name: Wilderness Volunteers Percentage: 65 Address: PO Box 22292 Flagstaff, AZ 86002 Street City State Zip Name: Aravaipa Running LLC Percentage: 35 Address: 2401 S 24th St Phoenix, AZ 85034 Street City State Zip Please read A.R.S. § 4-203.02 and R19-1-205 Special event license rules and Requirements. Declaration: . ij r 1, (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. Signature: Cave Headercon 5/5/2025 Page 3 of 3 Individuals requiring ADA accommodations please call (602)542-2999 The beer tent is a 20 ft x 20 ft tent with no walls. The tent is surrounded by wind fencing that’s 4 ft high. The wind fencing covers an area of 25 ft x 25 ft, creating a 5 ft uncovered patio on two of the sides. 4 that’s 6 ft wide. This entrance is manned by a certified employee There is one entrnace/exit a4 that will be checking ID’s for the ‘ y ; entirety of the event. All figures are to scale. ; . hes R Shy. ay aa