Westridge Pool Membership Form
Family Membership (2 adults and dependent children living in the same household)-$399

Grandparents Membership (2 adults and up to five grandchildren)-$399

Two Person (2 adults OR 1 adult and 1 dependent child living in the same household)-$339

Individual Membership (1 adult)-$339

$100 volunteer deposit is included in the membership dues. It is fully refundable once you have volunteered 4 hours at the pool.

Prior to the opening of the pool, payment can be mailed to PO Box 24029, Omaha, NE 68124, When the pool opens for the season, payment can be made at the pool. We accept cash or checks (make checks payable to Westridge Pool).

Westridge Pool Refund Policy: No refunds will be issued.

Email address *
First and Last Name of Adult 1 *
Your answer
First and Last Name of Adult 2 *
Mark NA if there is not a second adult
Your answer
Address *
Your answer
Main Phone Number for Adult 1 (XXX)XXX-XXXX *
Your answer
Main Phone Number for Adult 2 (XXX)XXX-XXXX *
Mark NA if there is not a second phone number
Your answer
Primary email address for adult 2 *
Mark NA if there is not a second email address
Your answer
Emergency Contact Name (an adult not listed on the membership form) *
Your answer
Emergency Contact Primary Phone Number (an adult not listed on the membership form) *
Your answer
Name of dependent child 1 *
Mark NA if you are not adding a child to your membership
Your answer
Age of dependent child 1 *
Mark NA if you are not adding a child to your membership
Your answer
Name of dependent child 2
Your answer
Age of dependent child 2
Your answer
Name of dependent child 3
Your answer
Age of dependent child 3
Your answer
Name of dependent child 4
Your answer
Age of dependent child 4
Your answer
Name of dependent child 5
Your answer
Age of dependent child 5
Your answer
Name of dependent child 6
Your answer
Age of dependent child 6
Your answer
Name of dependent child 7
Your answer
Age of dependent child 7
Your answer
I, the undersigned, hereby agree to discharge and hold harmless the association, officers, employees and members of Westridge Pool Association operations from all losses and damage that may occur as a pass holder of the pool. I understand this is a swimming pool facility and that certain dangers can be incurred as a user of these types of facilities. *
Digital Signature
Your answer
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