AQUA S.T.A.R. Canada

Lifeguarding Services Request Form

Personalized Swim Lessons in your area

Application: Mobile Lifeguarding Service Request

1Contact & venue

2Event details

3Participants & safety

4Open water details

5Confirmation message

Contact & venue

Who is requesting the service, where is it, and how do we reach emergency services.

Host First & Last Name

First

Last

Email Address

Phone Number

Event Site Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Does Host Own the Property Located at this Address?

If "No" Please Choose a Property Description

THIS INFORMATION MUST BE ACCURATE.

While we don't anticipate an incident requiring Emergency Medical Services, we MUST know what city or district will respond. Before answering this question, please call the non-emergency police department number for your event site address to confirm the EXACT NAME of the responding emergency services provider.

Responding EMS District

Please provide two cross-street names.

Nearest Intersection Street 1

Nearest Intersection Street 2

Please provide two cross-street names.

Parking Instructions

Please provide information that may assist lifeguards with access and departure.

Primary Emergency Contact Name and Phone

Enter the name and phone number of the person who should be contacted first in an emergency. This person must be reachable on the day of the event. Example: Sarah Campbell — +1 613 555 0192.

Secondary Emergency Contact Name and Phone

Enter a backup contact in case the primary contact cannot be reached. This should be a different person. Example: John Campbell — +1 613 555 0443.

Nearest Hospital Name and Approximate Distance

Search Google Maps for 'hospital near [your event address]' and enter the name and distance of the closest hospital. Example: Ross Memorial Hospital, Lindsay ON — 18 km. This is used to plan emergency response before the event.

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Open water details - READ CAREFULLY

This page appears only when a natural waterfront venue is selected. All fields are required for open water engagements.

We need the exact GPS coordinates of where participants will enter the water.

This is used to direct emergency services to the precise location — a street address is not sufficient for waterfront venues.How to find your GPS coordinates:

1. Open Google Maps on your phone or computer.
2. Navigate to the exact spot where swimmers will enter the water.
3. On a phone: press and hold your finger on that spot until a red pin appears. The coordinates appear at the bottom of the screen — tap them to copy.
4. On a computer: right-click on the exact spot. The coordinates appear at the top of the menu — click them to copy.
5. Paste the coordinates here. They will look like this: 49.0442, -121.9419

Important: coordinates must be for the water entry point, not your home address or a nearby road.

GPS Coordinates (Open Water Only)

A swim zone is the area where swimmers are permitted to enter the water.

Aquastar's insurance covers only swimmers within this zone.

If Yes (roped zone): you must email a photo of the marked zone to Lifeguard Service Email at least 48 hours before the event. Aquastar will review and confirm the zone before accepting your booking.

If No (landmark zone): you will describe two fixed reference points — Point A and Point B — that define the boundaries of the swimming area.

Swim Zone Definition (Open Water Only)

Yes — the swim zone will be marked with ropes or buoys on the day of the event
No — the swim zone will be defined by landmarks only

If Yes — Option A: Roped or Buoyed Zone

Swim zone dimensions (approximate, metres)

Enter the approximate length and width of the roped or buoyed swim area. Example: 20 metres wide by 15 metres long.

Estimated water depth within the zone

Describe the closest fixed landmark to the swim zone. Example: The roped zone is adjacent to the main dock. The far boundary is approximately 5 metres from the boat ramp.

If No — Option B: Landmark Boundaries

Point A — starting boundary

Describe the fixed landmark that marks one end of the swim area. Use a permanent, visible feature that the lifeguard can locate upon arrival. Example: The main dock at the end of the property. The concrete boat ramp. The large flat rock at the water's edge.

Point B — ending boundary

Describe the fixed landmark that marks the opposite end of the swim area. Example: The large oak tree at the shoreline, approximately 25 metres from the dock. The orange buoy. The retaining wall on the north side.

Approximate distance from Point A to Point B (metres)

Estimate the distance in metres between your two boundary points. If you are unsure, pace it out — an average adult step is approximately 0.75 metres. Example: 25.

Approximate water depth within the zone

Describe the approximate depth of the water between your two boundary points. Example: 1.0 to 1.5 metres throughout, or less than 1 metre near shore deepening to 2 metres at the far end.

Nearest dock, shore, or fixed reference point

Describe the closest fixed landmark to the swim area — not the boundary points themselves, but any nearby structure the lifeguard can use to orient themselves on arrival. Example: 5 metres from the main dock. Adjacent to the concrete seawall.

Watercraft Use (Open Water Only)

Will any participants use watercraft during this event?

Yes — participants will use watercraft (kayaks, paddleboards, canoes, inflatables, or similar)
No — no watercraft will be used by participants

This includes kayaks, paddleboards, canoes, inflatable floats, or any watercraft used by participants during the engagement — not emergency or rescue equipment.

Describe the watercraft and how they will be used

List the type and number of watercraft, and describe how participants will use them. Example: 4 paddleboards used by Girl Guides along the shoreline within the swim zone. 2 inflatable rings for young children in the shallow area near the dock.Note: Participants on watercraft must remain within the designated swim zone at all times. The lifeguard is not responsible for participants who exit the zone on watercraft.

Venue Hazard Assessment (Open Water Only)

Has this venue been assessed for underwater hazards?

Yes — this venue has been assessed for hazards
No — this venue has not been formally assessed
Unknown — I have not assessed or been informed of any hazards

Hazards include: rip currents, sudden depth changes, submerged rocks or objects, underwater obstructions, algae or plant growth, and uneven lake or sea floor. If you have used this venue before and are aware of any hazards, select Yes even if no formal assessment was conducted.

Who assessed the venue and when?

Enter the name of the person who assessed the venue and the approximate date. Example: John Smith (property owner), assessed June 2025. Municipal Parks Department, annual inspection May 2026.

Describe any known hazards, or write None

Describe every hazard you are aware of — no matter how minor. Be specific about location. Example:Large submerged rock approximately 3 metres from shore near the dock on the north side.Depth drops sharply to over 2 metres just past the rope line.Strong current present during high tide near the eastern boundary.If no hazards are known, write: None.

Acknowledgments (Open Water Only)

Weather and conditions confirmation

I confirm that to the best of my knowledge, conditions at the time of the engagement will be safe for open water activity: no lightning within 10 km, no sustained winds exceeding 20 km/h, no fog reducing visibility below 50 metres, and water visibility of at least 1 metre depth. I understand the lifeguard may terminate the engagement if conditions deteriorate on the day.

You must check this box to proceed. If you cannot confirm these conditions at the time of submitting, please contact Aquastar before submitting your request.

Zone compliance acknowledgment

I understand that Aquastar's insurance covers only swimmers within the designated swim zone. I understand the lifeguard operates from the shoreline and the swim zone is limited to safe rescue swim distance from shore. I am solely responsible for keeping all participants within the zone throughout the engagement. Any incident involving a swimmer outside the zone is my full liability.

You must check this box to proceed. Please read it carefully — this is a legal acknowledgment of your responsibilities as the event host.

File Upload

Drag & Drop Files, Choose Files to Upload, or Capture With Your Camera You can upload up to 10 files.

Location of the area, google map for enhanced service protection

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