City of San Pablo
Recreation Division
2450 Road 20
San Pablo, CA 94806
Field Rental Fee Waiver Application
ORGANIZATION DETAILS
Name of Organization:
Contact Name: Phone:
Organization Email Address:
Organization Mailing Address:
FEE WAIVER REQUEST DETAILS
Season:
Season Dates:
*Location Requested:
*If requesting the Davis Park location, your group must schedule a mandatory parent meeting to be had with Community Services and the Police Department to discuss parking restrictions to address public safety concerns.
Copies of the following items are required at the time of application submittal:
1) 501(c) Status / IRS documentation – Articles of Incorporation 2) Current Organization Roster of Membership
a) Roster must include player’s names, guardians, and addresses 3) List of Organization Officers and Contact Information 4) Certificate of Insurance
a) Must be valid for the season requested
b) List the “City of San Pablo” as the additionally insured party for the season 5) Copy of Organizations bylaws or articles of incorporation
CITY OF SAN PABLO STAFF USE ONLY
Received By: Date:
Council Review Date: Council Decision: Date:
Special Conditions:
San Pablo United Youth Soccer Club
Rafael Torres
510-367-9335
[email protected]
412 Mitchell Avenue San Pablo 94806
Fall 2022
Rumrill Sport Complex
July 25 to November 19th, 2022