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Brockville YMCA Pool Rental Request Form
First Name
*
Last Name
*
Email Address
*
Phone
*
Contact Person Date of Birth
*
Address
*
Address 2
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City
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State/Province
*
Zip/Postal Code
*
Country
*
Request Date of Rental
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Request Time of Rental
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Alternative Date
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Alternative Time
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Rental Options
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Lap Pool
Leisure Pool
Room Rental
General Purpose of Rental
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Expected Number of People Attending (Including Parents/Non-Participants)
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General Age of Majority of Participants
*
Is There Anything Else We Should Know About Your Rental Request?
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Requirements and Fees
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I have read the pool admission standards fee & payment information and day of rental information. I agree to adhere to all YMCA requirements if my rental is accepted.
Enter the code displayed
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