Online Form - Request for Hire - Shire of Coolgardie Aquatic Facilities

Name of Organisation

Name of Applicant

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