City of IGH Form Center

2. The name on this request is the person who will be held responsible for the terms of this permit.

4. Name of Applicant
5. Contact Person (If Different)
7. Name of League or Single Team
9. Organization
11. Address
13. City
14. ZIP Code
16. Home Phone
17. Cell Phone
18. Work Phone
20. Team Role
21. Email Address
25. Instructions

    Complete a separate row for each single-use date or range of dates, time requested, and field being requested. List field size and age, i.e. U13.

27. Field
28. Field Size
30. Calendar Dates
31. Days of Week
32. Time
36. Field
37. Field Size
39. Calendar Dates
40. Days of Week
41. Time
45. Field
46. Field Size
48. Calendar Dates
49. Days of Week
50. Time
54. Field
55. Field Size
57. Calendar Dates
58. Days of Week
59. Time
63. Field
64. Field Size
66. Calendar Dates
67. Days of Week
68. Time
72. Field
73. Field Size
75. Calendar Dates
76. Days of Week
77. Time
81. Field
82. Field Size
84. Calendar Dates
85. Days of Week
86. Time
90. This request is for:

    1. Public / Private School
    2. Local Youth Association
    3. Team Use
91. Sport
92. Year
96. For-Profit / Non-Profit Status

    1. For Profit
    2. Non-Profit
97. Non-Profit ID Number
99. Season

    1. Spring / Summer (April - mid August)
    2. Fall (Mid August - October)
101. Age Group

     1. Youth (Age 17 and Under)
     2. Adult
103. Are lights needed?

     1. Yes
     2. No

     There may be an additional fee for lights.

107. Did this team/league play on Rich Valley fields last year?

     1. Yes
     2. No
109. Additional Comments
Leave This Blank:


111. 1. Receive an email copy of this form.
112. Email address

     This field is not part of the form submission.

113. Submit

* indicates a required field