Section 1798.17 of the Civil Code requires this notice be provided when collecting personal information from individuals.
Each individual has the right to review personal information maintained by this agency, unless access is exempted by law.
GOLDEN BEAR PASS PROGRAM
APPLICATION INSTRUCTIONS: (NOTE: Completed application packets with all attachments submitted by mail will be
retained by California State Parks and cannot be returned.) Submit completed application and certification material and copy
of valid state-issued driver license or suitable photo Identification, and $5.00 payment (Check/Money Order/Credit) to:
2020 Calendar Year (January - December)
IN PERSON: BY MAIL:
At designated locations of the CA State Park System
(www.parks.ca.gov/passes - contact in advance to ensure availability);
Please allow 4-6 weeks for processing. Check/Money order payable to: "CA
Dept. Parks & Recreation" may be mailed with completed packets to:
California State Parks
Attn: Golden Bear Pass Program
P.O. Box 942896
Sacramento, CA 94296-0001
Park Pass Sales Office
1416 9th Street, Room 116
Sacramento, CA 95814
TERMS AND CONDITIONS OVERVIEW
Under the law, any qualifying person receiving Supplemental Security Income (SSI) [CA State Welfare and Institutions
Code Section 12200]; any person receiving aid under the applicable aid codes in the CalWORKS Program; or any person
qualified as listed on page 1, Section C (3&4) in accordance with the California Family Code (beginning at Section 297)
is eligible to receive the Golden Bear Pass upon application and payment of a $5.00 annual fee.
The Golden Bear Pass entitles the bearer and spouse or registered domestic partner entry to most California State Park
rated units where vehicle day use fees are collected at no charge.
Upon receipt of the Golden Bear Pass, pass holder agrees to the Terms and Conditions of this pass; violation could result in
pass revocation. For the complete list of Terms and Conditions inquire at the location of purchase or visit www.parks.ca.gov.
Terms and Conditions include, but are not limited to:
Pass must be renewed each calendar year and is valid for the use of the pass holder and spouse or registered domestic
partner only. Once pass is received, you may use passcard for applicable benefits.
Pass is issued as a personal benefit to the pass holder and spouse or registered domestic partner only (applicable only if
spouse or registered partner is named on passcard). The pass holder may not lend, loan, reassign, or resell their pass or
the privileges allowed by this pass to anyone else, including family members.
Pass holder and spouse or registered domestic partner (if applicable) must abide by any rules and regulations applicable
to California State Parks or to the use of this pass, as amended from time to time.
Pass is valid for one passenger vehicle with a capacity of nine persons or less where a vehicle day use fee is collected.
Not valid at units operated by federal or local government, private agencies or concessionaires. Pass may be used any
day of the week, including holidays, if space is available. Admittance and use subject to available space.
Pass holder is required to present the Golden Bear Pass (photocopies not accepted) and a valid state-issued driver
license or other suitable photo ID (interim/temporary not accepted) and pay any supplemental fees at the park.
To receive pass benefits at self-pay locations, pass holder must clearly display the pass & self-payment receipt on vehicle
dashboard visible through the windshield. Oversized vehicle fees will not be assessed; but, not all parks can accommodate.
Pass is not valid for resale or commercial use, industrial or business operations, including, but not limited to fleet use or
pooling. Pass shall not be assigned for profit and is void if misused.
Pass is not valid for per-person entry or tour fees (such as museums), boat use, camping, group use or sites, special
events, additional/extra vehicle fees, sanitation disposal use or for supplemental fees.
Pass is valid unless revoked. This pass cannot be used in conjunction with any other pass and/or discount, nor can it be
copied or altered in any way. Pass will be cancelled if the pass holder is found not to meet the pass qualifications.
All sales are final. No refunds, replacements or exchanges will be made for any reason including, but not limited to: loss
theft, park closures or environmental conditions such as low water levels, fire, or inclement weather. A lost or damaged
pass may be replaced only through reapplication and payment of $5.00 fee.
For any questions regarding the Golden Bear Pass, contact
CALIFORNIA STATE PARKS PASS SALES at
1-800-777-0369 ext. 2 or 916-653-8280.
Information on the application is considered personal. See Privacy Notice below.
Department of Parks and Recreation
Strategic Planning and Recreation Services
TITLE OF OFFICIAL RESPONSIBLE FOR MAINTENANCE OF THE INFORMATION
Staff Park and Recreation Specialist
BUSINESS ADDRESS OF OFFICIAL
1416 9th Street, Room 116; P.O. Box 942896, Sacramento, CA 94296-0001
AUTHORITY WHICH AUTHORIZES THE MAINTENANCE OF THE INFORMATION
Public Resources Code Section 5011 (added by Chapter 1303, Statutes of 1982)
THE FOLLOWING ITEMS OF INFORMATION ARE VOLUNTARY, ALL OTHERS ARE MANDATORY
All information requested on the application is mandatory with the exception of credit card information.
THE CONSEQUENCES, IF ANY, OF NOT PROVIDING ALL OR ANY PART OF THE REQUESTED INFORMATION
The applicant will not be issued a Golden Bear Pass.
THE PRINCIPAL PURPOSE(S) WITHIN THE AGENCY F OR WHICH THE INFORMATION IS TO BE USED
The information will be used to determine eligibility for issuance of Golden Bear Passes allowing use of State Park operated facilities where
vehicle day use fees are collected, at no further charge. Applications will be retained one calendar year from the end of the calendar year for
audit purposes, statistical data, and evaluation of the program.
KNOWN OR FORESEEABLE DISCLOSURES OF THE INFORMATION PURSUANT TO CIVIL CODE SECTION 1798.24, SUBDIVISIONS (e) OR (f)
Departmental Audits Office
DPR 578 (Rev. 1/2020)(Page 3 of 3)(Instructions, Terms and Conditions, Privacy Notice) DO NOT DUPLICATE APPLICATION