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Libertyville Recreation Pool Rental Form

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• Staff Contact: Collin Dulaney, cdulaney@libertyville.com, 224-636-2791 • No date holds & payment in full at time of submission • Alcohol/Smoking Prohibited. Food in Concession Area only. No reserved seating. • 10% Cancellation Fee (minimum 48 hour notice) • The Village of Libertyville reserved the right to cancel or reschedule • Morning parties- private swim lessons start at 11:30am (Adler Pool) • Rain Check: Call 224-636-2791 the day of to confirm.

� Libertyville spirit ofindependence

Adler Pool 1500 N Milwaukee Avenue Please Check Below & Write Date(s) D Morning 0 Night □ Slide Pool-$40 Additional

Adler Pool MORNING Rental (Max 50 Swimmers) FEE: $315 R/ $370 NR

1. Saturday or Sunday: 10am-11:30am (closed to the public until 11:30am) 2. Fee Includes Use of the Main Pool ONLY. Additional Fee for Main Slide. 3. Minimum 48 inches for Slide Pool.

Adler Pool NIGHT Rental (Max 200 Swimmers) FEE: $475 R/ $525NR

Date 1st Choice:

1. Friday or Saturday: 7:1Spm-8:4Spm (closed to the public) 2. Fee Includes Use of the Main Pool & Main Slide Pool 3. Minimum 48 inches for Slide Pool. *Dive Pool Closed for the Season*

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Date 2nd Choice: --------

Riverside Pool 870 Country Club Drive Please Check Below & Write Date(s)

Riverside Pool MORNING Rental (Max 25 Swimmers) FEE: 240 R/ $290 NR 1. Daily: 10am-11:30am (closed to the public) 2. Fee Includes Use of Pool. No additional pool available. 3. Smaller neighborhood pool. Riverside Pool Night Rental (Max 50 Swimmers) FEE: $265 R/ $315 NR 1. Daily: 6:15-7:45pm (closed to the public) 2. Fee Includes Use of Pool. No additional pool available. 3. Smaller neighborhood pool.

D Morning 0 Night

Date 1st Choice: ________

Date 2nd Choice: ________

Please complete the below. party is not reserved until payment is made. NO HOLDS

Name:_______________ Cell# ________________

Home Address:

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Email: ------------------------------------

Payment Due at Time of Reservation

TotalChargeAmount: _____________ Exp: _______ CVC:

Card#

Signature Approval for Payment & Waiver Cancellation Policy (Above)

X._______________________ Date: _____________

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