Name of Renter
Name of Partner
Address
City
Province
Postal Code
Phone Number
Estimated Due Date
Pool Pick-up Date
Pool Return Date (3 weeks later)
Name of Midwife
Which Midwife Office?
Email address
Accept Terms of Rental Agreement

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To book a birthing pool, first check on availability by calling Linda at 519-893-4436 or
by sending an email to linda@mothermewell.com . Then fill out the booking form
below and submit it. You will then be taken to a payment page. Your pool will be
reserved once your booking form and payment have been received. You will receive
a confirmation by phone or email that your birthing pool rental is reserved.
Birthing Pool Rental Agreement Terms
1.   The rental pool is strictly limited to indoor use only.
2.   Renter takes full responsibility for the manner in which, and the purpose for which the pool
is used.
3.   Renter will inspect all items in the pool kit and will do a set up of the pool upon arrival at
home with the pool and notify L’eau & Behold immediately if there is a problem with any
item in the pool kit.
4.   Renter will return the entire pool kit undamaged and thoroughly cleaned following its use as
outlined in the instructions included in the pool kit (see cleaning instructions in the kit).
5.   Renter agrees to pay for the replacement of the pool or any pool kit parts or accessories in
the event they are lost or damaged, or rendered unusable for future renters.
6.   Renter will make all arrangements for pick-up and return of pool on agreed dates. There
will be no reduction of the rental fee if the pool is returned before the end of the rental
period. There will be an additional rental charge of $50.00/week or part thereof beyond the
contract period. To avoid this charge the pool must be received by L’eau & Behold on the
agreed upon date or as agreed by L’eau & Behold. Late fee will be calculated at the end of
the agreed upon business day.
7.   Renter agrees to release and hold blameless L’eau & Behold and/or any agent thereof, it’s
members, employees and associates, as well as any pool manufacturer from any and all
responsibility or liability for maternal complications, infant mortality or morbidity, or injury to
any or all persons and facilities connected with the use of the rented pool that may occur
before, during, and/or after labour and birth in the pool provided.
8.   Refunds will be issued only if the baby is born prior to obtaining possession of the pool.
9.   Renter agrees to pay an additional $100.00 cleaning fee if the pool arrives back at L’eau &
Behold in a condition other than that outlined in the pool instructions.
10. L’eau & Behold will not be liable for any damage caused by improper use or misuse of the
pool or it’s equipment or as a result of damage to the pool caused by it’s user.
Payment:
100.00 deposit at time of booking
  75.00 when pool is picked up
175.00  Total