• 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 the area

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

• Referee Administration Area (please describe suitable coverage and proximity to pitch[es]:

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

• 1:

• 2:

• 3:

• 4:

• 5:

• Changing Facilities:    Yes ______      No ______

• Bleachers:    Yes ______      No ______

     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 additional information you wish to be considered, i.e., other venues  

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