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CITY OF LEWISTON APPLICATION FOR THE USE OF ATHLETIC FIELDS Complete and return twenty (20) days before event. DATE OF APPLICATION: TOURNAMENT/PROGRAM DIRECTOR: TELEPHONE: ADDRESS: CITY: STATE: TOURNAMENT/PROGRAM NAME: TOURNAMENT/PROGRAM DATES: EVENT TIME: FRIDAY Begin: End: SATURDAY Begin: End: SUNDAY Begin: End: DESCRIPTION OF EVENT: PURPOSE OF EVENT (i.e. fund-raising, profit-making, etc.): ANTICIPATED ATTENDANCE (estimate): ADMISSION FEE/DONATION? YES NO If yes, specify amount: $ SITES REQUESTED: Marcotte (Lights: YES NO @ $35.00/night) LAP Randall (Field: R1 R2 R3 ) Franklin Pasture (Baseball Softball Other ) Holy Family TOTAL NUMBER OF GAMES TO BE PLAYED: ---PAGE BREAK--- FEES AGRICULTURAL AND GROOMING MATERIALS Truck Rental (Includes Maintenance Person) # X $ per hour = $ Field Marker Unit # X $ per day = $ Lime # of bags X $ per bag = $ Rake, shovels and string # of days X $ per day = $ Marcotte lights # of games X $35.00 per game = $ SUBTOTAL = $ TOTAL SITE COST = $ FIELD USE FEE League Games $24.00 per game Tournament Games $ 9.00 per game # of games X $ per game = $ Other Programs Negotiated Price = $ TOTAL FEES & CHARGES = $ I have reviewed the policy pertaining to use of athletic fields under the jurisdiction of the Lewiston Department of Recreation, and agree to be bound by its terms. Signature of applicant or authorized representative Date TO BE COMPLETED BY CITY Acted on by Director: DATE: Acted on by Field Use Review Committee and/or CITY COUNCIL: DATE: Action taken: Granted Granted with Conditions Denied CONDITIONS IMPOSED: SECURITY: SECURITY DEPOSIT: INSURANCE: ADDITIONAL FEES (state amount and reason): OTHER: DATE: BY: Parks and Recreation Director FEE PAID: RECEIPT DATE: BY: