Anderson Township Park District - 2010 Soccer Field Request

2010 Competitive Spring Soccer Practice Field Request Form

Deadline for form submission: March 18
Fields open for practice: March 23

IMPORTANT - PLEASE READ!

Anderson Township residents receive first priority to secure Anderson Township Park District (ATPD) practice fields. To be considered for a practice field, each team MUST submit this request form and their team roster. Teams with the highest number of Anderson residents will be given first consideration of their desired location and times. If 2 requests come in on the same day with the same percentage of Anderson residents, the team that turned in their request earliest in the day will be given priority.

Each roster will be audited for the percentage of residents and fields will be released after the residency percentage has been calculated. Fields will be distributed after the deadline. To request a practice field, you must properly complete the form. Incomplete forms will be handled after all properly completed forms have been processed. Phone requests will not be taken. Clear Creek Park fields will be available for practice by renting the entire field, with a limit of one team per field. Lines and goals are not guaranteed until the first scheduled league game.

Your permit will be e-mailed or mailed to you. Your payment, in full, by check, credit card or cash is due no later than 2 weeks after your permit date. Neither credits, nor refunds will be issued for a rain out, however, an additional day will be offered, if available.

Remember to check the ATPD’s Field Status Hotline, 513-357-6629, before playing/practicing on a field. Users who play on a closed field are subject to a $150.00 fine and possible suspension for 1 year.

Help preserve the fields… avoid practicing in the goal mouth areas!

Spring Soccer Practice Field Request From
Return this completed form with roster by the deadline.
One Request per form.

Organization Name:
Starting (weekly) practice Date:
Ending (weekly) practice Date:
Requesting Name:
Requesting Person's Address:
City:
State:
Zip:
Home Phone Number:	Fax Number:
Work Phone Number:	Email Address:

INDICATE YOUR DIVISION:
FIELD SIZES:

Dribbler/Trapper
Comp 6v6, Flyers, Wings
Comp 8v8

Shooter/Passer
Striker/Kicker/Minors (full)

Whole field rental at Clear Creek Park is available for practice (1 team per field) by permit only. No ½ field rentals available at Clear Creek Park. All other locations are available for ½ field rental. Players must be the appropriate age for requested field size. D/T request are 1 hr. time slots; all other field sizes are 1.5 hour time slots.

Would you like to practice with another team? Yes No
Coach's Name

1^st Choice

1^ST CHOICE FOR LOCATION:

Clear Creek Park
Full, Comp 8v8,
Comp 6v6, Flyers/Wings,
Shooter/Passer
(Whole Field Rental)

Juilfs Park
Shooter/Passer
(Half field & 1.5 hr. time slot)

Kellogg Park
Comp 6v6,
Shooter/Passer
(Half field & 1.5 hr. time slot)

Riverside Park
Dribbler/Trapper
(Half field & 1 hr. time slot)

1^ST CHOICE FOR DAY OF WEEK:

Monday

Tuesday

Wednesday

Thursday

Friday

1^ST CHOICE FOR EVENING TIME:

4:00-5:00pm (D/T)	5:00-6:00pm (D/T)	6:00-7:00pm (D/T)	7:00-8:00pm (D/T)
4:00-5:30pm	5:30-7:00pm	7:00-8:30pm	D/T are 1 hr. time slots. All others are 1.5 hr. time slots.

2^nd Choice (if 1 ^stchoice cannot be fulfilled)

2^ND CHOICE FOR LOCATION:

Clear Creek Park
Full, Comp 8v8,
Comp 6v6, Flyers/Wings,
Shooter/Passer
(Whole Field Rental)

Juilfs Park
Shooter/Passer
(Half field & 1.5 hr. time slot)

Kellogg Park
Comp 6v6,
Shooter/Passer
(Half field & 1.5 hr. time slot)

Riverside Park
Dribbler/Trapper
(Half field & 1 hr. time slot)

2^ND CHOICE FOR DAY OF WEEK:

Monday

Tuesday

Wednesday

Thursday

Friday

2^ND CHOICE FOR EVENING TIME:

4:00-5:00pm (D/T)	5:00-6:00pm (D/T)	6:00-7:00pm (D/T)	7:00-8:00pm (D/T)
4:00-5:30pm	5:30-7:00pm	7:00-8:30pm	D/T are 1 hr. time slots. All others are 1.5 hr. time slots.

Player Roster Information:
Please enter up to 22 players in the following format:
Players Name, Street Number, Street Name, City, State, Zip, Phone
ie: John Doe, 123, Main Street, Cincinnati, OH, 45244, 513-555-5555
(separate name, street number, street name, city, etc. with commas)

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.

APD uses Secure Socket Layer (SSL) technology to send your personal information to our server.

APD Employee Login. ©Copyright 2005-2009:Anderson Township Park District.