2023 Pool Membership Application

"*" indicates required fields

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Email (Secondary)

Phone*

Spouse Name (only if joining)

First Last

Pricing & Payment Information

All payments must be made online at the time of registration to secure your membership. A family member constitutes an immediate family member in the same household.
Children 2 and under are free, do not list name and birthdate.
Babysitters may be listed, with their full name and birthdate.
Senior Citizens only membership $350, couple $600. Use dropdown box listed. At this time walk-in registration is not available.

Registration Pricing*

$400 fee per member, $350 for seniors 65+. Children 2 and under are free and should NOT be listed on application. There is a $15 administrative fee per registration.
**Your total is based on the number of members.

Select the TOTAL number of members registering*

ATTENTION: Be sure to enter in the total number of family members here, including yourself, as this will determine the total amount you pay online.

Select the TOTAL number of members registering*

ATTENTION: Be sure to enter in the total number of family members here, including yourself, as this will determine the total amount you pay online.

Processing Fee*

Price:

Online Registration Total

Additional Family Members Joining

Please provide the first and last name (if differs) of all members except those 2 and under.
6 digit birthdate must be given for each member (ie: 10/09/70)

First Member - $400*

First Last Birthdate

2nd Member - $700

First Last Birthdate

3rd Member - $750

First Last Birthdate

4th Member - $800

First Last Birthdate

5th Member - $850

First Last Birthdate

6th Member - $900

First Last Birthdate

7th Member - $950

First Last Birthdate

8th Member - $1000

First Last Birthdate

Coupon

Credit Card*

Card Details

Cardholder Name

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Comments

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