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2. First Name*
3. Last Name*
5. Organization
7. Address1*
9. Address2
11. City*
12. State*
13. Zip*
15. Phone*
16. Email:*
18. Which pool or pool package would you like?*
    -- Select One --High School PoolWealthy PoolWealthy Pool Party Package
19. Purpose/Activity:*
21. Date of rental:*
    Date of rental:
22. Rental time slot:

    1. Request a time slot
    2. I am flexible with my rental time

    Preferred rental times are 2 hour blocks:

    12:30-2:30PM or 4:30-6:30PM

23. Preferred time slot:
    Preferred time slot: Start Time

    —

    Preferred time slot: End Time

    Please type in your desired start and end time.

25. What ameninities will you need?

    1. Extra Lifeguard
    2. Tables
    3. Chairs
    4. Multi Purpose Room
    5. Assistance for person with disabilities
    6. Diving Boards (High School Pool Only)
26. How many people will be attending?*
    -- Select One --1-1011-1516-2525-5050-100100 +200 +
27. What is the average age of participants?*
29. Special requests
31. Pool Rules
    Pool Rules

    Must read and understand pool policies and rules.
32. Are you a:*
    -- Select One --ResidentNon-Resident
34. Agreement:*

    1. I Agree

    Applicant hereby releases the City of East Grand Rapids, its officers, agents, and employees from all liability and waives any and all rights and claims for injuries or damages arising from the use of City facilities. In addition, applicant agrees to indemnify the City, its officers, agents, and employees from and against any and all claims, judgements, losses, damages, and legal proceedings arising out of or resulting from the use of City facilities. Applicant has read all rental terms and pool rules attached and agrees to follow adhere to said terms and rules. I understand that all information submitted to the City of East Grand Rapids is considered public information and subject to disclosure under the Freedom of Information Act.
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36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field