Aquatic Center Group Rate Form • City Of Jeffersonville Parks Department

Group Rate for Aquatic Center

Complete this form to apply for a group rate and request a date. Approval is based on availability and weather. You will receive an email from Olivia Mann for approval. *Must have prior approval before bringing your group to the pool*

Name(Required)

First Last

Organization(Required)

Email(Required)

Enter Email Confirm Email

Phone(Required)

Organization Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Representative Date of birth(Required)

This information is required in our booking system.

Requested Date(Required)

Date approval is based on availability and weather

Arrival Time(Required)

Arrival and departure times available only during regular business hours

Departure Time(Required)

Number of Attendees(Required)

Total number including staff. Limit 100

Info About Group(Required)

Please indicate if there are any special needs for your group, or other info we should know.