2023 Eastmoor Pool Membership Registration Form
Eastmoor South Recreation Park
PO Box 091095 Columbus, OH 43209
735 Eastmoor Blvd.43209

OPENING DAY: Saturday, May 27, 2023
*Rates are staying the same as 2022*
Email *
Adult 1, Last Name *
Adult 1, First Name *
Adult 1, Email *
Adult 1, Phone Number *
Adult 1, Home Address *
If applicable: Adult 2, Last Name
If applicable: Adult, 2 First Name
If applicable: Adult 2, Email
If applicable: Adult 2, Phone
Children Name(s), Birthdate:
Emergency Contact (name, relationship, phone) *
If you are a Eastmoor Pool Bond Owner, enter your Bond # below (Note: shareholders with a valid bond receive a 10% discount with proof of bond):
Membership Categories and Rates (please select one) *
Please indicate how you plan to pay for your 2023 Eastmoor Pool Membership: *
By typing my name below, I confirm that this information is correct, and I agree to submit my payment in the manner indicated above. *
A copy of your responses will be emailed to the address you provided.
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