Pool Key Request Form

Resident Name(s) (required)

Property Street Address (required)

Contact Email (required)

Contact Phone (required)

Reason for Key Issuance (required)

New homeowner and/or pool key never issued in prior years

Replace lost key

Other

If other, please explain:

Which District do you reside? (required)

BNC Metro District #1

BNC Metro District #2

Other

I acknowledge that the pool key is property of the District. I also acknowledge that failure and/or the failure of our guests to follow the rules of the pool may result in the confiscation of this pool key. (required)

Yes

No

I acknowledge that, in the event the pool key is lost or destroyed, a replacement key will be issued at a cost of $20 payable to the District. (required)

Yes

No

I acknowledge that, per District policy, only one key is issued per household. (required)

Yes

No

I agree to not share this pool key with anybody living outside of our household. (required)

Yes

No

I agree to not make copies of this key (required)

Yes

No

(IF REPLACEMENT ONLY) I agree to pay the District $20 for this replacement key. Further, I acknowledge that, upon receipt of the billing statement from the District, failure to pay the $20 replacement fee may result in the District levying fines and interest on my account.

Yes

No

Resident Signature (required)