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2. Formal Field Use Request

   FORMAL FIELD USE is for organizations scheduling ongoing use throughout a season, or groups scheduling ten (10) or more dates. Organizations with four (4) teams or more are eligible to participate in each season's field allocation process. For more information, email Scott Purdy, Park Operations Manager (scott.purdy@bothellwa.gov).

4. Do I qualify to participate in seasonal field allocation?
   Field Allocation Process (PDF)
5. Verifying player residency
   Am I a Bothell Resident? (PDF)
9. Organization/Group Name*
10. Field Scheduler Name*

    This person will be the single point-of-contact with the City of Bothell throughout the scheduled season.

12. Address*
14. City*
15. State*
16. Zip Code*
18. Phone Number*
19. Email*
23. PARTICIPANT INFORMATION

    Seasonal field allocation is based off of the number of Bothell residents inside the city limits that participate in each organization, based on the previous season’s registration numbers. Organizations must submit a verified list (see “Am I a Bothell Resident?” PDF, above) of their players that reside in Bothell’s city limits to City staff by each season’s deadlines. List must include the following information for each player: 1) Name and/or organization ID #, 2) Address, 3) School district. | To see if you qualify for participation in seasonal field allocation, see "Field Allocation Process" (top of page).

25. Participants*

    1. Youth
    2. Adults
26. Total # participants in organization:*
27. # participants within Bothell city limits:*
29. # participants within Northshore School District:*
30. # participants outside Northshore School District:*
34. EQUIPMENT STORAGE

    Organizations may store large equipment (goals, pitching mounds, etc) at fields throughout their scheduled use, if desired. A $250/season equipment storage fee applies, due prior to field use. Staff will provide instructions to organizations as to where at the fields equipment should be stored. | Bothell Parks & Recreation is not responsible for any theft or damage to equipment stored at our fields.

36. Are you planning on storing equipment at the fields this season?*

    1. Yes
    2. No
37. If yes, please specify (type/# of equipment, which field(s), etc.):
39. Equipment lock combinations:

    Organizations are required to provide their own cables/locks for securing equipment. Please provide combination numbers so Parks & Recreation can move them to perform field maintenance, if needed.)

43. FIELD REQUEST INFORMATION

    Please submit a new request for each change in location OR field use (ex: one request for North Creek Sportsfield practices, one for North Creek Sportsfield games, one for Doug Allen practices, etc.). A SUBMITTED REQUEST FORM DOES NOT GUARANTEE THE AVAILABILITY OF REQUESTED FIELDS OR DATES/TIMES.

45. FIELD REQUEST #1
47. Field(s) (check all that apply:)*

    1. North Creek #1 (synthetic)
    2. North Creek #2 (synthetic)
    3. North Creek #3 (grass)
    4. North Creek #4 (synthetic)
    5. Doug Allen #1 (grass)

    1. Doug Allen #2 (grass)
    2. Doug Allen #3 (grass)
    3. Doug Allen #4 (grass)
    4. Cedar Grove (grass)
48. Day(s) of week (check all that apply):*

    1. Sunday
    2. Monday
    3. Tuesday
    4. Wednesday

    1. Thursday
    2. Friday
    3. Saturday
50. Dates requested (start-finish):*
    Dates requested (start-finish): Start Date

    —

    Dates requested (start-finish): End Date
51. Times requested (start-finish):*
    Times requested (start-finish): Start Time

    —

    Times requested (start-finish): End Time
53. Additional comments (opt):

    Please list preferred field(s), preferred night(s) of the week, any dates not needed in the range, etc.

55. Activity type:*

    1. Game
    2. Practice
    3. Other
56. Sport:*

    1. Soccer
    2. Slow Pitch
    3. Baseball
    4. Fast Pitch
    5. Lacrosse
    6. Football
    7. Other (please specify)
57. Other:
59. Max # participants using a field at one time:
61. Field prep (check all that apply):*

    1. 60' bases
    2. 65' bases
    3. 40' pitching rubber
    4. 46' pitching rubber

    1. 50' pitching rubber
    2. Soccer goals
    3. Other
    4. No prep required
62. Other prep: (Subject to availability. Additional fees may apply.)
64. FIELD REQUEST #2
66. Field(s) (check all that apply)

    1. North Creek #1 (synthetic)
    2. North Creek #2 (synthetic)
    3. North Creek #3 (grass)
    4. North Creek #4 (synthetic)
    5. Doug Allen #1 (grass)

    1. Doug Allen #2 (grass)
    2. Doug Allen #3 (grass)
    3. Doug Allen #4 (grass)
    4. Cedar Grove (grass)
67. Day(s) of week (check all that apply):

    1. Sunday
    2. Monday
    3. Tuesday
    4. Wednesday

    1. Thursday
    2. Friday
    3. Saturday
69. Dates requested (start-finish):
    Dates requested (start-finish): Start Date

    —

    Dates requested (start-finish): End Date
70. Times requested (start-finish):
    Times requested (start-finish): Start Time

    —

    Times requested (start-finish): End Time
72. Additional comments (opt):

    Please list preferred field(s), preferred night(s) of the week, any dates not needed in the range, etc.

74. Activity type:

    1. Game
    2. Practice
    3. Other
75. Sport:

    1. Soccer
    2. Slow pitch
    3. Baseball
    4. Fast pitch
    5. Lacrosse
    6. Football
    7. Other (please specify)
76. Other:
78. Max # participants using a field at one time:
80. Field prep (check all that apply):

    1. 60' bases
    2. 65' bases
    3. 40' pitching rubber
    4. 46' pitching rubber

    1. 50' pitching rubber
    2. Soccer goals
    3. Other
    4. No prep required
81. Other prep: (Subject to availability. Additional fees may apply.)
83. FIELD REQUEST #3
85. Field(s) (check all that apply):

    1. North Creek #1 (synthetic)
    2. North Creek #2 (synthetic)
    3. North Creek #3 (grass)
    4. North Creek #4 (synthetic)
    5. Doug Allen #1 (grass)

    1. Doug Allen #2 (grass)
    2. Doug Allen #3 (grass)
    3. Doug Allen #4 (grass)
    4. Cedar Grove (grass)
86. Day(s) of week (check all that apply):

    1. Sunday
    2. Monday
    3. Tuesday
    4. Wednesday

    1. Thursday
    2. Friday
    3. Saturday
88. Dates requested (start-finish):
    Dates requested (start-finish): Start Date

    —

    Dates requested (start-finish): End Date
89. Times requested (start-finish):
    Times requested (start-finish): Start Time

    —

    Times requested (start-finish): End Time
91. Additional comments (opt.):

    Please list preferred field(s), preferred night(s) of the week, any dates not needed in the range, etc.

93. Activity type:

    1. Game
    2. Practice
    3. Other
94. Sport:

    1. Soccer
    2. Slow pitch
    3. Baseball
    4. Fast pitch
    5. Lacrosse
    6. Football
    7. Other (please specify)
95. Other:
97. Max # participants using a field at one time:
99. Field prep (check all that apply):

    1. 60' bases
    2. 65' bases
    3. 40' pitching rubber
    4. 46' pitching rubber

    1. 50' pitching rubber
    2. Soccer goals
    3. Other
    4. No prep required
100. Other prep: (Subject to availability. Additional fees may apply.)
102. FIELD REQUEST #4
104. Field(s) (check all that apply):

     1. North Creek #1 (synthetic)
     2. North Creek #2 (synthetic)
     3. North Creek #3 (grass)
     4. North Creek #4 (synthetic)
     5. Doug Allen #1 (grass)

     1. Doug Allen #2 (grass)
     2. Doug Allen #3 (grass)
     3. Doug Allen #4 (grass)
     4. Cedar Grove (grass)
105. Day(s) of week (check all that apply):

     1. Sunday
     2. Monday
     3. Tuesday
     4. Wednesday

     1. Thursday
     2. Friday
     3. Saturday
107. Dates requested (start-finish):
     Dates requested (start-finish): Start Date

     —

     Dates requested (start-finish): End Date
108. Times requested (start-finish):
     Times requested (start-finish): Start Time

     —

     Times requested (start-finish): End Time
110. Additional comments (opt):

     Please list preferred field(s), preferred night(s) of the week, any dates not needed in the range, etc.

112. Activity type:

     1. Game
     2. Practice
     3. Other
113. Sport:

     1. Soccer
     2. Slow pitch
     3. Baseball
     4. Fast pitch
     5. Lacrosse
     6. Football
     7. Other (please specify)
114. Other:
116. Max # participants using a field at one time:
118. Field prep (check all that apply):

     1. 60' bases
     2. 65' bases
     3. 40' pitching rubber
     4. 46' pitching rubber

     1. 50' pitching rubber
     2. Soccer goals
     3. Other
     4. No prep required
119. Other prep: (Subject to availability. Additional fees may apply.)
123. ORGANIZATION AUTHORITY*

     In the event the applicant is a corporation, partnership, association, club, team or group, the person signing this agreement for such entity represents to the City that he/she has full authority to sign such contract and, in the event that he/she is not so authorized that he/she will be personally liable for the faithful performance of this agreement. The terms, conditions, policies and procedures along with this form shall constitute a contract between the applicant and the City of Bothell. 

     1. I certify that this is true, and that I am the correct point-of-contact with the City of Bothell for this season.
     2. No, I am not the correct point-of-contact for this season.
125. WAIVER OF LIABILITY*

     The undersigned hereby requests of the City of Bothell, use of the facilities above and certifies that the information in this request is true and correct. The undersigned agrees to exercise the utmost care in the use of these facilities and property and by signing below the applicant hereby agrees to indemnify, defend and hold harmless the City, its elected and appointed officials and employees while acting within the scope of their duties, from any and all claims, demands and causes of action of any kind or character, foreseen or unforeseen, for damages including but not limited to personal injury, death or property damage as well as the cost of defense costs, court costs, witness and attorneys’ fees, in any way arising out of the granting of this permit or arising out of the City’s sole negligence. Applicant expressly waives his/her immunity under Title 51 of the Revised Code of Washington, the Industrial Insurance Act, for injuries to his/her employees and agrees that the obligation to indemnify, defend and hold harmless provided for in this paragraph extends to any claim brought by or on behalf of any employee or representative of the applicant. I have received, read, understand and agree to abide by the field use Policies and Procedures contained in the Field Scheduling Guide. 

     1. I agree
     2. I do not agree
127. AGREEMENT

     I understand that by submitting this request form, I am not guaranteed the availability of requested fields or dates/times and I must wait for staff confirmation/a Facility Use Agreement before using fields for their requested purpose.

129. Please type your name/signature:*
130. Date:*
     Date:
Leave This Blank:


132. 1. Receive an email copy of this form.
133. Email address

     This field is not part of the form submission.

134. Submit

* indicates a required field