City of Ann Arbor Ice Rental Agreement
Organizations Name:___________________________ Contact Person:_________________________ Contact Person’s Address:______________________________________________________________
(street, city, state, zip)
Contact Person’s Phone:______________________________/_________________________________
Day - include area code Evening - include area code
Contact Person’s Fax:_________________________ Email Address:___________________________ include area code Proposed Facility Use:__________________________________________________
party, practice, etc
Rental Days/Date:___________________________________ Rental Time:_____________________ Estimated Number in Rental Group:__________ Rental Skates Needed?:__________________________
party, practice, etc
I, the rental applicant, have read the attached pool rental policies, swimming pool rules, and rental rate information. I ce rtify by my signature that I agree to abide by these policies and pay the applicable rental fees. I will share theses policies with others in our group for compliance by our group. __________________________________________________ signature __________________________________ date
Payment Information – Staff Use Only
Deposit Payment: cash check credit card atm debit Ann Arbor Gold
Deposit Payment Date:_______________
Deposit Payment Amount:_______________
Staff:______________________________ If check, check number:_________________ Balance Amount Due:_________________ ------------------------------------------------------------------------------------------------------------------------------------Balance Payment: cash check credit card atm debit Ann Arbor Gold Balance Payment Date:_______________ Balance Payment Amount:_______________ Staff:______________________________ If check, check number:__________________
Buhr Seasonal Users
Hourly Rates: Prime Time Non-Prime Time Resident $150.00 $110.00 Non-Resident $200.00 $135.00
Buhr One-Time Users
Hourly Rates: Prime Time Non-Prime Time Resident $162.50 $130.00 Non-Resident $200.00 $162.50
*Saturdays, Sundays and after 3 p.m. Monday to Friday are considered prime time days. Dec.24, 2008, to Jan.2, 2009, is considered prime time (Ann Arbor Public School winter break).