CITY OF CASA GRANDE COMMUNITY SERVICES DEPARTMENT PALM ISLAND FAMILY AQUATICS CENTER POOL RESERVATION APPLICATION

Name: ______________________________________

D.O.B: ___________

Phone:_____________

Mailing Address: _______________________________________________________________________ Organization (if applicable): ______________________________ Email: __________________________ Alternate Contact: _________________________ Phone: ______________ Relation: _______________ Pool Rental (Available on select Fridays – Saturdays – Sundays) Fees:

Parties less than 100 guests - $310

Parties of 100 or more - $360

$200 fee due at time of reservation Circle Day and Time Requested : Friday Time: 5:00 – 7:00 p.m.

Saturday

7:30 – 9:30 p.m.

Sunday

Rental Date:_______________

Expected Number of Guests: _______________

All reservations will include lifeguards, admission fees and Ramada E directly next to the Aquatics Center. Any food or drink brought to the rental must remain at the Ramada and will not be allowed inside of the facility. Alcohol and tobacco products are not permitted. All pool rentals must abide by the facility rules as well as any additional instructions from pool staff. Everyone attending the party will be counted towards total guests, non-swimmers included. All fees must be paid at the Parks and Recreation office 14 days in advance of rental date. If you cancel less than 14 days in advance of your requested date, NO REFUNDS WILL BE GIVEN. If circumstances are such that the City deems it appropriate to cancel the reservation due to a dust storm, equipment problems, etc., all rental fees will be refunded or credited either partially or fully. ___________________________________ Signature

______________________________ Printed

_____________ Date

Payment Method

□ Cash

□ Check #______

□Visa

□MasterCard

Name on Credit Card: _________________________________________ Card Number

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CVC 3-digit Security Code:

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Expiration Date:

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Authorized Cardholder Signature __________________________

City Staff Use Only:

Rental Fee Amount: $310____ Date Due: __________

$360____

Amount Paid: _________

Amount Due: ___________