Resident Pool Membership Application "*" indicates required fields PhoneThis field is for validation purposes and should be left unchanged.Family Name*Address*Building Number*Select Building Number12345678910111213141516171819E19W20E20WApartment Number*Email* Phone Number*Cell Phone NumberAlternate Phone NumberApplicantsPROOF OF RESIDENCY: COPY OF DRIVERS LICENSE FOR EACH ADULT MEMBER AND A PHOTO FOR EACH CHILDAdultsChildrenChildNumber of Adults*–01234516 YEARS OF AGE AND OVER (AS OF MAY 1, 2026)Number of Children*–0123452 TO 15 YEARS OF AGE (AS OF MAY 1, 2026)Number of Child Applicants*–012345UNDER 2 YEARS OF AGE (AS OF MAY 1, 2026)Total Adult 1 Name*License*Max. file size: 128 MB. Adult 2 Name*License*Max. file size: 128 MB. Adult 3 Name*License*Max. file size: 128 MB. Adult 4 Name*License*Max. file size: 128 MB. Adult 5 Name*License*Max. file size: 128 MB. 2-15 year old Child 1*DOB*Photo*Max. file size: 128 MB. 2-15 year old Child 2*DOB*Photo*Max. file size: 128 MB. 2-15 year old Child 3*DOB*Photo*Max. file size: 128 MB. 2-15 year old Child 4*DOB*Photo*Max. file size: 128 MB. 2-15 year old Child 5*DOB*Photo*Max. file size: 128 MB. Under 2 year old Child 1*DOB*Photo*Max. file size: 128 MB. Under 2 year old Child 2*DOB*Photo*Max. file size: 128 MB. Under 2 year old Child 3*DOB*Photo*Max. file size: 128 MB. Under 2 year old Child 4*DOB*Photo*Max. file size: 128 MB. Under 2 year old Child 5*DOB*Photo*Max. file size: 128 MB. Rules and Regulations*1) THE POOL IS A TOTALLY SMOKE FREE ENVIRONMENT. 2) Photo i.d. must be presented at all times before entering the club. Membership may not be transferred, and membership will be revoked if used by any person other than the registered member. 3) Children under the age of 16 will not be admitted unless accompanied by an adult, who shall be responsible for their safety and proper conduct. 4) Management reserves the right to limit the number of members. Management shall have the right to expel a member for not following all rules. 5) No soliciting of any kind. 6) Before entering the pool, all bathers must observe the sanitary regulations of the Health Department as may be posted by Management. 7) Use of pool when a lifeguard is not on duty is prohibited. Lifeguards have full authority to expel or discipline any violators of the pool regulations. Diving from sides of the pool is prohibited. 8) There is to be no sitting, standing, or diving off the ledge of the pools or blocking the steps leading into the pool. 9) Infants and toddlers must wear rubber pants over diapers at the kiddie pool. Children who wear diapers are not allowed in the main pool. Children 8 years and older are not allowed in the kiddie pool. Parents must remain inside the kiddie pool gate with the child. 10) Swimming and the use of all facilities, is at the individual’s own risk and responsibility. Management assumes no responsibility whatsoever for personal injury of any kind resulting directly or indirectly from the use of the facilities by any members. 11) Coolers must not exceed the approved size, and we reserve the right to inspect bags. 12) The use of a radio is restricted to headphones only. 13) Management reserves the right to close the pool and/or club for maintenance purposes, inclement weather, or to alter or change the hours of operation without notice. 14) Management is not responsible for any personal items. Any items left will be discarded daily. 15) There will be no refunds under any circumstances. 16) I understand that the use of the pool facilities is subject to all rules and regulations. The rules and regulations may be changed, amended or added to, at any time by Management. Any infraction of these rules or objectionable conduct, as now or hereafter in effect, shall subject the violator to disciplinary measures; such as suspension, loss of privileges or the revocation of membership without refund. I agreeSignature*Please type your name to sign