• VENUE:

• DATE:

• Number of Available Pitches:

    • Size of Available Pitches:

iRB Regulation

Other

Pitch 1:

Pitch 2:

Pitch 3:

Pitch 4:

• Barriers:

• Goal Posts - Please describe by Pitch •

Permanent

Temporary

Pitch 1:

Pitch 2:

Pitch 3:

Pitch 4:

• Changing Facilities:

• If 'Yes' please describe:

• Trainers - Availability:

 • Doctor - Availability:

• Distance from nearest Hospital:

• Ambulance Service (describe availability to venue):

• Concession Area (proximity to Field[s], and what is available for purchase):

    • Rugby Vendor (Midwest RFU sponsor must be given first right of refusal) - Please describe area

available for vendor[s] to set up shop or restrictions you may have at your venue:

• Referee Admin Area (please describe suitable coverage and proximity to field[s]:

• Hotels in Area (list lodging and room costs by distance from the Venue:

• 1:

• 2:

• 3:

• 4:

• 5:

• Changing Facilities:

• Bleachers:

If 'Yes' please describe - include capacity:

• Proposed Entrance Cost:

• Bathrooms:

Describe as Permanent or Temporary:

     • PA System:     Yes ______      No ______

• Use the space provided below for any further information you wish to be considered, i.e., other venues

   hosted, experience, potential sponsors, etcetera, etcetera . . .