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APPLICATION FOR ACCESS TO BURKETOWN AQUATIC FACILITY

Name
DOB
Postal
Address

Mobile
Email
The swimming pool fees (including GST) for 2016-2017 are as follows
Daily Access

5800-1500-0000

$ 7.70

Per Week Access

5800-1500-0000

$ 50.60

Per Month Access

5800-1500-0000

$ 125.40

Per Six Month Access

5800-1500-0000

$ 148.50

12 Month Access

5800-1500-0000

$ 184.80

The code issue fees cover the adult user of the code as well as their immediate
family.
Misuse (as deemed by CEO or approved council officer) of a code will result in
access being cancelled and in the event of a cancellation any unused fee is not
refunded. Membership is non transferable.
Pool opening hours are:
o Monday to Sunday 7am 7pm

By signing this agreement you accept the Access Rules and Conditions on page two. In
addition I understand that my failure to comply with any of the conditions will result in the
cancellation of my Access code and forfeiture of Fees Paid.
Signature of Applicant: _______________________________________________
Date:
_______________________________________________
OFFICE USE ONLY
Amount paid
Receipt number

Eft/Chq/Cash

Pin Number

Register updated

BCS/CP/SB/BAC/M

Fill in application Return to Burke Shire Council


Aquatic Centre Membership Form ADM-FRM-015

Access Rules and Conditions


Rules include:
1. No Running or Pushing
2. No Food or Drinks are permitted
3. No Alcohol
4. No Jumping, Bombing, Dunking or Diving
5. No Littering please use the bins provided
6. No Bicycles
7. No Smoking
8. No Glass
9. Animals are not permitted
10. All patrons must shower before entering the Pools
11. Appropriate swimwear must be worn at all times whilst in the Pools
12. No access when suffering from any contagious disease (e.g. diarrhoea, meningitis)
13. Children must be supervised by an adult at all times
Disobeying of any of these rules will result in your suspension from the use of the Aquatic Facility.
Risks Associated With Swimming Pool Complex:
Council has provided the Burketown municipal swimming pool for enjoyment by the public, but Council warns all
prospective entrants to the pool complex that, irrespective of the purpose for which you enter, there may be dangers to
person and property posed by:

The nature of the facility (in particular, a body of water in which persons swim, and into which they may fall);

The condition of the facility;

Operations being conducted at the facility;

The actions, intentional or careless, of persons at the facility, including persons not authorised to be there;

Weather conditions (notably lighting).


Supervision of Users:
Council does NOT provided a lifeguard or other monitoring or supervision at the pool complex. Adults enter and use the
complex at their own risk.
The supervision of children and other persons unable to properly provide for their own safety remains AT ALL TIMES the
responsibility of their PARENTS OR GUARDIANS.
Persons under age 18 ARE NOT PERMITTED TO ENTER the pool complex UNLESS accompanied by the PARENT
OR GUARDIAN.
Council may refuse any person permission to enter the pool complex, and may require any person to leave the complex,
at Councils absolute discretion and without giving a reason.
Disclaimer:
Burke Shire Council accepts no responsibility for ensuring the safety or security of persons who enter the swimming pool
complex. In particular, Council accepts no contractual obligation, no general law duty and no statutory duty of care to
ensure the safety of persons or their property within or near the pool complex, and I accept that Council will not be
responsible to any person, under any circumstance, for:
Death, illness or injury suffered at the pool complex, resulting from an occurrence there; or

Loss or destruction of, or damage or injury to, the property of any person at the pool complex, or resulting
from anything that occurs there.
Release and Indemnity:
Irrespective of whether they do so with Council permission and irrespective of whether they pay Council a fee for
permission to do so, persons using the Burketown municipal swimming pool complex do so upon the following
conditions:
1.
Each person who uses the complex acknowledges that, together with those in his/her care, he/she attends
and uses the complex voluntarily, fully appreciating and accepting the risk that he/she, and any person in
his/her care, may suffer or sustain at the complex, or as a result of something that occurs there, illness,
injury, death, or property loss or damage, irrespective of cause.
2.

Each such person releases Council, its employees and contractors from responsibility for illness, injury or
death, and for property loss, destruction or damage the person suffers or sustains, irrespective of cause,
while at the pool complex or as a result of anything that occurs there.

3.

Each such person undertakes to indemnify Council, its employees and contractors against any liability, loss
or expense sustained or incurred by them or any of them through being held responsible for;

Illness, injury or death to that person, or to any person in that persons care; or
Property loss, destruction or damage sustained by that person, or sustained by the owner of
any property in that persons possession or under his/her control, or in the possession or under
the control of anybody in that persons care,
At the pool complex or as a result of something that occurs at the complex.

Fill in application Return to Burke Shire Council


Aquatic Centre Membership Form ADM-FRM-015