Outdoor Facility and Field Use Permit Application

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This form must be completed by any team, league, organization or individual(s) wishing to hold an activity on ANY OUTDOOR town recreational field or facility. Form must be filled out and submitted at least 4 weeks prior to event, along with COVID control plan, Certificate of Liability Insurance and payment. Forms submitted after this date may not be considered for approval. Checks are made payable to WESTERLY RECREATION DEPARTMENT; 15 Church Street, Bradford, RI 02808

Town of Westerly Recreation Department, 15 Church St. Bradford, RI 02808

League/Organization Name *

Check which box applies *

Youth League/Program

Adult League/Program

Other/Special Event (Town of Westerly Special Event Permit may be required)

Required

Director's/Applicant's Name *

Address *

Telephone Number *

E-Mail Address *

Type of Sport *

Baseball

Basketball

Lacrosse

Soccer

Softball

Tennis

Volleyball

Other

Required

If you checked "Other" above, please specify

Number of Teams *

Total Number of Participants *

Start Date *

YYYY

End Date *

YYYY

Start Time *

Time

End Time *

Time

Field/Facility Requested *

Cimalore Complex

Craig Field

Gingerella Sports Complex

Rotary Park

Required

Number of Games/Sessions Scheduled per Week *

Number of Weeks in Session *

Days of the Week Requested *

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Required

Field Use Fee Schedule *

Cimalore Baseball Field (up to 3 hrs per day) $75 per day

Cimalore Baseball Field (3 or more hrs per day) $150 per day

Cimalore Women's Field (up to 3 hrs per day) $60 per day

Cimalore Women's Field (3 or more hrs per day) $120 per day

Cimalore Lower Field #1 (up to 3 hrs per day) $50 per day

Cimalore Lower Field #1 (3 hrs or more per day) $100 per day

Cimalore Lower Field #2 (up to 3 hrs per day) $50 per day

Cimalore Lower Field #2 (3 hrs or more per day) $100 per day

Cimalore Micro Field (up to 3 hrs per day) $50 per day

Cimalore Micro Field (3 hrs or more per day) $100 per day

Cimalore Pavilion $30/day

Craig Field (up to 3 hrs per day) $50 per day

Craig Field (3 hrs or more per day) $100 per day

Craig Field Pavilion $30/day

Gingerella Small Field (up to 3 hrs per day) $40 per day

Gingerella Large Field (up to 3 hrs per day) $50 per day

Gingerella Large Field (3 hrs or more per day) $100 per day

Gingerella Pavilion $30/day

Rotary Park Tennis Court/Pickleball Court (up to 3 hrs per day) $25 per court per day

Rotary Park Tennis Court/Pickleball Court (3 hrs or more per day) $50 per court per day

Rotary Park Volleyball Court (up to 3 hrs per day) $25 per court per day

Rotary Park Volleyball Court (3 hrs or more per day) $50 per court per day

Required

All (Leagues/Organizations/Groups/Individuals) are Required to Pay an Annual $50 Administrative Fee. Above referenced fees may be adjusted for tournaments and/or by vote of Recreation Board. Checks payable to WESTERLY RECREATION DEPARTMENT; 15 Church Street, Bradford, RI 02808. COVID Control Plan and Certificate of Liability Insurance MUST be provided to the Westerly Recreation Department before activity start date. *

I agree to pay all said fees (all amounts listed in the Field Use Fee Schedule above) Fees to be collected immediately after Rec Board Approval and prior to use of facility

I agree to submit COVID Control Plan NO LATER than 2 weeks prior of activity start date

I agree to submit Certificate of Liability Insurance naming Town of Westerly as "Additionally Insured"

Required

Digital Signature (by printing name below, you agree that you have read all aforementioned terms of this agreement, agree to adhere to all policies set forth by the Town of Westerly and Westerly Recreation Department and all COVID guidelines. *

Date of Application Request *

Submit

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