Tuscola (IL) Pool Pass

Tuscola (IL) Pool Pass

Please complete this form to purchase your 2022 Tuscola Pool Pass or passes

The Tuscola (IL) Swimming Pool offers two types of passes for each season:

Number of entry pass

20 entries - $50

50 entries - $100

Season Pass

Sold in individual or group passes
A season pass is used by only the passholder and for an unlimited number of entries
8 individual passes may be purchased together if using the same address
Cost*: $35 per person

*An additional card processing fee will be added to on-line orders

Choose the type of Pool Pass you want: *

Season Pass for Individual or Group 10 Entries - $30 20 Entries - $50 50 Entries - $100
Choose the type of Pool Pass you want:

Season Pass for Individual or Group 10 Entries - $30 20 Entries - $50 50 Entries - $100
Number of Season Passes requested for this household *
Group passes may contain up to 8 individuals
Number of Season Passes requested for this household
Duplicate hidden field for number of passes
First Pass Name *

First Name Last Name

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email *
example@example.com
Phone Number *
Please enter a valid phone number.
Emergency Contact Name *
The emergency contact will be used by Tuscola Pool staff in the event of an emergency involving the pass holder.
Emergency Contact Phone Number *
Please enter a valid phone number.

First Season Passholder Information
Name on First Season Pass

First Name Last Name
Is this passholder under 10 years of age?

YES NO
Passholder date of birth

Month Day Year
Date
Take a photo of the individual on this Season Pass: (Head/shoulders shot only, similar to a driver's license photo)
OR upload a photo from your device

Cancel of

Second Passholder Information
Name on Second Season Pass

First Name Last Name
Is this passholder under 10 years of age?

YES NO
Passholder date of birth

Month Day Year
Date
Take a photo of the individual on this Season Pass: (Head/shoulders shot only, similar to a driver's license photo)
OR upload a photo from your device

Cancel of

Third Passholder Information
Name on Third Season Pass

First Name Last Name
Is this passholder under 10 years of age?

YES NO
Passholder date of birth

Month Day Year
Date
Take a photo of the individual on this Season Pass: (Head/shoulders shot only, similar to a driver's license photo)
OR upload a photo from your device

Cancel of

Fourth Passholder Information
Name on Fourth Season Pass

First Name Last Name
Is this passholder under 10 years of age?

YES NO
Passholder date of birth

Month Day Year
Date
Take a photo of the individual on this Season Pass: (Head/shoulders shot only, similar to a driver's license photo)
OR upload a photo from your device

Cancel of

Fifth Passholder Information
Name on Fifth Season Pass

First Name Last Name
Is this passholder under 10 years of age?

YES NO
Passholder date of birth

Month Day Year
Date
Take a photo of the individual on this Season Pass: (Head/shoulders shot only, similar to a driver's license photo)
OR upload a photo from your device

Cancel of

Sixth Passholder Information
Name on Sixth Season Pass

First Name Last Name
Is this passholder under 10 years of age?

YES NO
Passholder date of birth

Month Day Year
Date
Take a photo of the individual on this Season Pass: (Head/shoulders shot only, similar to a driver's license photo)
OR upload a photo from your device

Cancel of

Seventh Passholder Information
Name on Seventh Season Pass

First Name Last Name
Is this passholder under 10 years of age?

YES NO
Passholder date of birth

Month Day Year
Date
Take a photo of the individual on this Season Pass: (Head/shoulders shot only, similar to a driver's license photo)
OR upload a photo from your device

Cancel of

Eighth Passholder Information
Name on Eighth Season Pass

First Name Last Name
Is this passholder under 10 years of age?

YES NO
Passholder date of birth

Month Day Year
Date
Take a photo of the individual on this Season Pass: (Head/shoulders shot only, similar to a driver's license photo)
OR upload a photo from your device

Cancel of

You have requested a {chooseThe} pool pass to the Tuscola (IL) swimming pool at Ervin Park in Tuscola, IL for {firstPass}.
You have requested {numberOf} Season Pass(es) to the Tuscola (IL) swimming pool at Ervin Park in Tuscola, IL. The pass(es) will be in the following name(s):

{nameOn}

{nameOn29}

{nameOn34}

{nameOn40}

{nameOn46}

{nameOn52}

{nameOn58}

{nameOn64}
Total Cost for Pool Passes requested on this form *
This total includes a card processing fee.
How do you want to receive your pool pass? *

Electronic Pass e-mailed to you (ASAP during business hours) Pick up at Tuscola Pool front desk (1-2 business day after purchase) Pick up at Tuscola Water Department (1-2 business day after purchase) by U.S. Mail (within 2-5 business days)

Pool Pass(es) Total Cost

USD Description