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2. Lebanon Memorial Pool Group Use Form
   The intended purpose of this form is to request usage of the pool for groups with 10 or more participants (ex: summer camp, day care, etc.). This form does not guarantee approval of group usage. Please wait for a follow-up email or phone call to confirm. If you are looking to rent the pavilion for a party, please visit LebanonNH.gov/Register.
4. Group Name*
5. Contact Person*
7. E-Mail Address*
8. Phone Number*
10. Number of Children*
11. Number of Staff/Adults*
13. Days, Dates & Times Requested*
    Please enter the days, dates and times you would like to bring your group.
14. Additional Comments
16. Group Use Policies
    By submitting the form, you agree to the following:

    • The rate for groups from Lebanon or West Lebanon are $1 per youth.
    • Groups outside of Lebanon or West Lebanon are $2 per youth.
    • Staff members and/or Adults may not have cell phones on the pool deck.
    • There needs to be at least half of the staff members and/or adults in the water with their children when the children are swimming.
    • If children need lifejackets, the ratio changes to 1 staff member/adult to 3 children within an arm's reach.
    • If a child has a behavioral/medical diagnosis, the staff members/adults must inform the Pool Director, Assistant Director, or Head Guard on duty.
    • Visits must be scheduled at least 5 days in advance. Cancellations must be notified to the Pool Staff as soon as possible.
    • Staff and children numbers must be provided to Lebanon Memorial Pool 24 hours ahead of time.
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18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field