BERLIN FIELD USE REQUEST FORM SEASONAL USE/ONE DAY USE

User Priority List:
· Tier 1. Recreation Events
· Tier 2. 100% Berlin Youth Sport Groups and 100% Berlin Residents Adult and Children
· Tier 3. Berlin Youth Groups and Tahanto Region High School Sports Teams
· Tier 4. Out of Town Rentals

NEW: All teams or leagues MUST provide insurance! You must list the town of Berlin as a co-insurer and have a 1 million-dollar liability.

Group Name: _______________________________________
Contact Person _______________________________________
Address: _______________________________________
Home Phone: _______________________________________
Work Phone: _______________________________________
E-mail: _______________________________________

Fee Schedule for Obtaining a Permit:
· $300 Donation/Field for the season
· $50 Donation/1 Day Field usage

Seasons are as Follows:
Spring: April 1 – June 30
Summer: July 1 – August 31 (Summer camps, Tryouts)
Fall: September 1 – November 30
Winter: December 1 – March 31 (closed)

Schedule for your Team:
Season: _______________________________________________
Dates: _______________________________________________

Practice Days:
Mon Tues Wed Thurs Fri Sat Sun (Please Circle)
Dates & Times: ________________________________________

Game Days:
Mon Tues Wed Thurs Fri Sat Sun (Please Circle)
Dates & Times: ________________________________________

Please mail this form with the fee and copy of Insurance to:
Berlin Recreation Committee, PO Box 274, Berlin, MA 01503-0274