Request for Hire - Aquatic Facilities » Coolgardie Shire Council

Name of Organisation

Name of Applicant*

Phone Number*

Email Address (your booking confirmation will be sent to this address)*

BOOKING DETAILS - Facility Requested*

Kambalda Aquatic FacilityCoolgardie Swimming Pool

Purpose of Function*

Food Consumption*

YesNo

Number of Persons*

Have you used this Facility before*

YesNo

Date(s) Requested*

Start Time (incl. set up)*

Finish Time (Inc. Clean up)*

EQUIPMENT (check all required) - Items marked with an * will be at an additional cost.

TablesBBQ’sSmall inflatables* Lane Hire – number of lanes* Additional Lifeguard* Large Inflatable includes Lifeguards* After Hours Hire includes Pool Operator

Special Instructions/ Additional Information

Do you agree to adhere to the terms and conditions (please see link above to download full terms and conditions.) By ticking yes, you confirm agreement with conditions.*

YesNo