Request: Access to PAC during School Hours
As approved by the PAC Joint Powers Board, school aged youth are allowed at PAC during school hours only when actively supervised by an adult (age 19+). One exception includes the following:

Youth, ages 16+, may access PAC during school hours with a parent/guardian request. Requests should be made for a specific time (limited to two hours per day) and will be approved for the duration of the semester term in which the request is submitted.

Parent/Guardian, please complete this form to request access for your student (age 16+) to access PAC during regular school hours. This form will need resubmitted each semester. All students are required to sign in with a membership or pay daily admission ($3/day). Visit our website www.pinedaleaquatic.com for membership options.
Sign in to Google to save your progress. Learn more
Parent Name *
Parent Contact Information (Phone & Email) *
Student Name *
What days of the week and time frame are you requesting access? (Example: Mon & Wed from 1:20-3pm). *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Pinedale Aquatic Center. Report Abuse