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2. Northern Lights Aquatic Centre - Pool Rental Request Form
   This is your organizations formal request for pool space. Verbal requests will not be accepted.
4. Organization Name *
5. Contact Name *
7. Organization/Contact Email *
8. Contact Phone*
10. Address*
12. City*
13. Province*
14. Postal Code*
18. Days of the week requesting*

    1. Monday
    2. Tuesday
    3. Wednesday
    4. Thursday
    5. Friday
    6. Saturday
    7. Sunday
19. Requested Number of Hours (per day)*
21. Start Date & Time*
    Start Date & Time

    Start Date & Time
22. End Date & Time*
    End Date & Time

    End Date & Time
24. Requested Pool Space (entire pool, number of lanes etc.)
28. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
30. Electronic Signature*
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit Submit and Print

* indicates a required field