Bagdouma swim pass application 2023

Bagdouma Swim Pass Application Instructions

This application is being used to verify applicants' eligibility to receive scholarship for a swim pass, offered by the City Of Coachella.

The City Of Coachella is providing swim passes to Coachella residents for the summer months. Each qualified applicant is eligible for ONE Open Swim / Lap Swim Pass to access Bagdouma Community Pool Operated by DRD at NO COST.

Please follow the instructions below to insure timely processing of your application:
Bagdouma Swim Pass Application
Participant's Name
Telephone (required)
Address
City & State
Zip
Participants Date of Birth

MonthDayYear
Date
Swim Pass Rule and Regulations

Pass is only good for 10 punches into the Bagdouma Pool. Every entry into the pool is considered one punch. I.E. Morning swim and night swim will receive one punch each. Children under the age of 14 be accompanied by an adult to use the pass. Lost cards will not be replaced.

Add Additional Family Members Below
Last
First
Date of Birth

MonthDayYear
Date
Last
First
Date of Birth

MonthDayYear
Date
Last
First
Date of Birth

MonthDayYear
Date
APPLICANT STATEMENT: I hereby certify that the information on this form is accurate and complete.
Signature

Clear
Date

MonthDayYear
Date
File Upload

Provide a current utility bill / Piece of mail and ID (Showing you are a Coachella Resident)
Cancelof
Should be Empty: