Field Rental Payment Form

Rentals at the Citizens Bank Fields at Progin Park in Lancaster, MA are accomplished through Massachusetts Youth Soccer's Events and Programs Coordinator Jen Fickett. This form shall be used for the payment of Field Rental fees only. Should you have any questions about field rentals at our complex or if you do not receive email confirmation of your payment, please contact Jen Fickett.

* Organization

* First Name

* Last Name

* Street Address

Address Line 2

* City

* State

* Zip Code

* Phone Number

* Email Address

Fax

* Number of Fields

* Number of Time Slots

* Number of Dates

Invoice Number or Payment Identifer (if available)

* Amount Due
(use XX.XX format, no $ symbol)

* Indicates Response Required