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Rock River Rapids Facility Request

2. 

4. Organization/Individual*

5. Today's Date*
   Today's Date

7. First Name*

8. Last Name*

10. Address*

12. City*

13. State*

14. Zip*

16. Phone*

17. Email*

19. Day Requested*

    1. Friday
    2. Saturday
    3. Sunday

    After Hour Rentals are from 7:45-9:30pm.

20. Date Requested*
    Date Requested

22. Pool(s) Requested*

    1. Entire Facility
    2. Lap Pool
    3. Shallow Pool
    4. Shallow Pool and Lazy River

23. Attendance Expected*

    Additional $1.00 charge for every person over 750

25. Special Request*

26. Food Served*

    1. Outside Catering
    2. Concession Stand ($75.00)
    3. No Food

28. Rental Fees

29. Fees Paid

    1. Cash
    2. Check
    3. Credit Card

Leave This Blank:


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

    This field is not part of the form submission.

33. Submit

* indicates a required field