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1407 Putnam Pike, Chepachet, Rhode Island |
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Date: _______________
Requestor: _________________________ Organization:
_____________________
Please specify which field(s) is being requested per the layout
below
by checking field number.
Note: Field One is the closest one to Putnam Pike.
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Please circle the following information in each
category concerning your request:
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Program:
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Fall Recreation
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Spring Competitive
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Soccer Camps
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Other Requests:___________________________________________
Repetitive Requests:
Every (week day) ___________ starting date: ________ ending date: ____________
Start time:____________ end time: __________
Single event:
Date: _________________ start time: _____________ end time: ______________
I agree to follow all rules and regulations established by the BGYSA Board of Directors when using the above facility. Violating any of the rules and/or regulations may result in the revocation or suspension of this permit.
Address: _____________________________________________________________
Town / Zip: ___________________________________________________________
Phone: ______________________________________________________________
Facility rules: Obey all posted signs, no alcoholic beverages, no smoking or tobacco use, no abusive language, no littering, no pets allowed on property.
All requests should be made 30 - 45 days in advance for approval process.
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