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2. San Miguel County’s Placerville Park, which includes the park open space, picnic shelters, horse shoe pits, and basketball court may be reserved for events. This reservation request form does not include the Placerville Historic School House or playground. Placerville Park may be reserved, free of charge, for events up to 49 people. A $100 refundable damage and clean-up deposit may be required for high impact uses. Special events (50-150 people) must enter into a separate Use License Agreement. Reservation requests must be made at least 1 week in advance of the requested date. Please turn this form in to the Open Space and Recreation Department located at 333 West Colorado, 3rd Floor, Telluride or submit electronically.

4. Placerville Park Use Policies
   Placerville Park Use Policies (PDF)
6. Date Requested*
   Date Requested Start Date

   Date Requested Start Time

   —

   Date Requested End Date

   Date Requested End Time
8. Area(s) Needed:*
10. Organization
12. Contact Person*
14. Mailing Address*
16. City*
17. State*
18. ZIP*
20. Daytime Phone*
21. Email
23. Briefly describe your event.*
24. Number of partipants*
26. Park Rules
    • Dogs must be restrained by leash or on strict voice command at all times. Please clean up after your pet.
    • No motorized vehicles are permitted in the park or on the pathways.  
    • Please plan to park in the designated parking areas and carry your food, drink and equipment into the park area.
    • This is an outdoor venue and is subject to weather conditions and flooding. Please cancel or postpone your event if flooding rains or lightning occurs.
    • All tents or structures must use weighted barrels as tie downs. No driven stakes are permitted in irrigated areas.
    • The event organizer and its participants are responsible for all clean up after their use. Please bring extra trash bags to pack out your event trash and avoid overfilling park trash used by the public. Any clean-up time provided by the Park staff will be billed to the event organizer at a rate of $35 per hour plus cost of repairs or supplies.
    • This no fee reservation is non-exclusive to the public.
    • All park users shall comply with all posted park rules and act in a responsible manner.  
    • Failure to comply with park rules or acting in an inappropriate manner may result in the immediate cancellation of your event at the discretion of any County staff person.
28. Acknowledgement
    I have read, understand, and agree to all the terms stated above for the use of Placerville Park. I understand that this form is only a request for use and additional requirements may need to be fulfilled through a Use License Agreement. I also agree to waive all claims against San Miguel County for any injury, loss of property or accident that may occur during the reservation.
30. Acknowledgement*

    By typing your name and date above, you are electronically signing the document and agree to abide by the document provisions according to the Uniform Electronic Transactions Act, C.R.S. §24-71.3-101 et seq.

31. Date*
    Date
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field