Form Entry - Pool Use Agreement

Property Street Address:

*

Homeowner Name:

*

Phone Number:

*

Type of Phone:

HomeWorkMobile

*

Current Mailing Address (if other than the above listed property address)

Street Address:

City:

State:

Zip Code:

Would you like to receive future District newsletters, announcements and other updates via email?

Opt-In?

YesNo

Email Address:

Is the property currently being used as a rental property?

YesNo

*

Pool Key #

Do NOT have pool key. Pool Key Request Form will be sent to the District Manager.

Individuals (first and last name AND AGE) living at the above property address other than the property owners:
Note: You Must List all three pieces of information for each entry or the form will be rejected.

1. Resident's Full Name

Resident's Age

2. Resident's Full Name

Resident's Age

3. Resident's Full Name

Resident's Age

4. Resident's Full Name

Resident's Age

5. Resident's Full Name

Resident's Age

6. Resident's Full Name

Resident's Age

7. Resident's Full Name

Resident's Age

8. Resident's Full Name

Resident's Age

Note: Pool privileges will not be granted unless a "yes" response is provided to each statement.

YesNo

*

I have read and agree to abide by the District’s current pool rules.

YesNo

*

I will ensure all individuals living at this address and any guests will be made aware of the District’s current pool rules and will agree to abide by such rules before they enter the pool area.

YesNo

*

I acknowledge that failure to abide by the District’s current pool rules may result in suspension of pool privileges of some or all individuals living at this property address (including guests).

YesNo

*

I acknowledge that failure to abide by the District’s current pool rules may result in suspension of pool privileges of some or all individuals living at this property address (including guests).

YesNo

*

I acknowledge (1) the pool monitor is not a lifeguard and (2) I will inform all individuals living at this property address and related guests—before they enter the pool area—that the pool monitor is not a lifeguard.

By entering my email address and clicking submit, I certify that the above information is, to the best of my knowledge, true and accurate.

Email (required)

*