Athletic Field Reservation Request

2. Name of Organization and/or Troop Number (if applicable)

4. First Name*

5. Last Name*

7. Address1*

9. City*

10. State*

11. Zip*

13. Primary Phone Number*

14. Alternate Phone Number

16. Email Address

17. Verify Email Address Again

19. Day & Date Requested*

20. Time Requested*

21. Estimated guest count:*

23. Sand Creek Field(s) Requested:*

    1. Field 1
    2. Field 2
    3. Field 3
    4. Field 4
    5. Field 5
    6. Sand Creek East
    7. Sand Creek West

24. Soccer Complex

    1. Field 1
    2. Field 2
    3. Field 3
    4. Field 4
    5. Field 5
    6. Field 6

25. Al Flynn Park

    1. Field 1
    2. Field 2
    3. Field 3

26. Wintercrest

    1. East
    2. West

28. Woodcrest

    1. Disc Golf

30. Purpose of Use:*

32. Have you rented with us before?*

    1. Yes
    2. No

34. How did you hear about us?*

    1. I live in Coon Rapids
    2. I've attended another event here
    3. Web search

    1. Facebook
    2. Twin Cities Gateway
    3. Other

36. Applicant agrees to protect, indemnify, defend, save and hold harmless the city of Coon Rapids and its officers and employees from any and all claims, liabilities, damages or right of action directly or indirectly arising out of the use of facilities. I affirm that the above statements are true and I further affirm that I have read and understand all policies and information and that I am 18 years of age or older.

    Applicant agrees to protect, indemnify, defend, save and hold harmless the city of Coon Rapids and its officers and employees from any and all claims, liabilities, damages or right of action directly or indirectly arising out of the use of facilities. I affirm that the above statements are true and I further affirm that I have read and understand all policies and information and that I am 18 years of age or older.

38. Signature of Applicant*

39. Date*

41. This application is not a valid contract until appropriate fees have been received by the City of Coon Rapids and the contract is signed by the Facility Coordinator. Applicant will be notified when application is approved or denied.

    This application is not a valid contract until appropriate fees have been received by the City of Coon Rapids and the contract is signed by the Facility Coordinator. Applicant will be notified when application is approved or denied.

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42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit Submit and Print

* indicates a required field