VILLAGE OF GILBERTS
APPLICATION FOR PERMIT TO RESERVE
BALL FIELD
PLEASE PRINT THE INFORMATION BELOW
Applicant(s) Information – Individual/Group/Organizationxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Name of Individual/Organization: _________________________________________________
Address: _____________________________________________________________________
(street)
(city)
(zip)
Telephone: (Days) _________________________ (Evenings) __________________________
___ Gilberts Resident
___ Gilberts Non-Profit Organization
___ Gilberts Business
Contact Person
___ Non-Resident
___ Non-Gilberts Non-Profit Organization
___ Non-Gilberts Business
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Name: _______________________________email: __________________________________
Address: ____________________________________________________________________
(street)
(city)
(zip)
Telephone: (Days) ________________________ (Evenings) ___________________________
Event Informationxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Date(s) of Event: __________________________, 201___. Use reverse side if necessary.
Time of Event: _____________a.m./p.m. to _______________a.m./p.m. (no later than dusk)
Number of persons expected to participate: ________________________________________
*Certificate of Insurance ___ Yes ___ Not Applicable / Payment:___Yes___Not Applicable
Signature of Applicant: ________________________________________________________
Printed Name of Applicant: _________________________________Date: _______________
* A Certificate of Insurance is required for liability purposes and must be submitted with the
application before the permit can be issued. Individuals/Organizations will be permitted use of
the ball field 2 times per month at no charge. There will be a $25 fee charged for use of the ball
field for 2 or more uses per field per month.
To ensure your reservation, insurance forms, liability waiver and payment, if applicable, must
accompany your request for permit.