Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

COVID-19 Small Business Food/Beverage Establishment To-Go Boxes Assistance Application for Castle Rock Water

  1. CRWaterFinal
  2. COVID-19 Small Business Customer Assistance Application for Castle Rock Water
  3. Program information
    The Castle Rock Water Small Business Food/Beverage Establishment To-Go Box Assistance program is intended to help Castle Rock Water customers financially impacted by the COVID-19 pandemic. This program is open to all small business, non-home-based, food and beverage establishments in the Town of Castle Rock that have a Castle Rock Water account. This program is based on a first come, first served basis and supplies are limited. Full program details are available at
  4. Castle Rock Water account number not required for this application.
    We understand that many restaurants do not own their building and are not responsible for the water account.
  5. What are the impacts to your business from COVID-19?*
    Please check all that apply.
  6. Number of employees prior to COVID-19:*
  7. Number of current or anticipated employees as a result of COVID-19 impacts:*
  8. Current or anticipated revenue reduction related to COVID-19 impacts?
  9. Acknowledgements
    Please check each statement, acknowledging you have read and affirm the information being submitted within this application is true and accurate to the best of your knowledge.
  10. Typing your name above constitutes a legal signature whereby you are confirming the information provided in this form is true and correct to the best of your knowledge.
  11. 220 boxes come in a case. How many to-go boxes do you anticipate needing in a single week? A maximum of 4 cases per week is available. You will be contacted regarding actual quantities and pickup times available.
  12. We'd like to spread the word about water conservation and water quality to your customers and thus require a 'sticker' be attached to the to-go boxes. Due to health regulations, these are not preaffixed, but will be provided upon box pickup. To retain the recyclability of the boxes, these are sticky notes not stickers. Please acknowledge that you will attach the message to the boxes.

  13. Questions?
    Contact Castle Rock Water, 720-470-0123 or
  14. Note: Information provided in this application is considered a public record and may be subject to public disclosure through the Colorado Public Records Act.
  15. Leave This Blank:

  16. This field is not part of the form submission.