HSTC Membership Form 2022
Huntington Swim and Tennis Club Membership Information and Contact Form
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Email *
Bondholder Last Name *
Bondholder (Primary) First Name *
Bondholder (Secondary) First Name
Street Address *
City *
State *
Zip Code *
Email | Bond Holder (Primary) *
Phone Number Type | Bond Holder (Primary) *
Phone Number | Bond Holder (Primary) *
Phone Number Type | Bondholder (Secondary)
Phone Number | Bondholder (Secondary)
Phone Number Type | Other
Phone Number | Other
Emergency Contact | Name *
Emergency Contact | Phone Number Type *
Emergency Contact | Phone Number *
Total number of household members (including bondholder(s)) *
Household Member/Children Names & Ages
Please provide the names and ages of any/all *non-bondholder* household members and/or children in the questions below.

Please leave blank if it does not apply (e.g. no additional names beyond bondholder(s), or the amount of household members/children is less than the number of potential responses provided).
Household Member/Child (1) Name
Household Member/Child (1) Age
Household Member/Child (2) Name
Household Member/Child (2) Age
Household Member/Child (3) Name
Household Member/Child (3) Age
Household Member/Child (4) Name
Household Member/Child (4) Age
Household Member/Child (5) Name
Household Member/Child (5) Age
Household Member/Child (6) Name
Household Member/Child (6) Age
Additional names & ages of household members/children if amount is greater than 6
Caregiver/Nanny:
2022 Membership Level
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Payment Options | Annual Membership Dues
Electronic payments may be sent to the pool via the huntingtonpool@gmail.com email address using the following platforms:
Zelle
Paypal*

Check payments may be mailed to:
HSTC
PO BOX 201
Naperville, IL 60566

*If paying via PayPal please indicate the payment is being sent to Friends/Family (the pool is charged a transaction fee if not). When using PayPal a 2.99% fee for the use of a Credit Card or Debit Card. If using either please send the following amounts:

Equity Membership: $618
Maintenance Membership: $309
Trial Membership: $721
Payment Type *
Payment Amount (please include additional transaction fees as outlined above) *
Check Number (enter N/A if NOT paying by check) *
Electronic Payment Transaction Number (enter N/A if paying by check) *
Proxy Vote for New Board Members: Please vote for the HSTC member listed below. The elected members will become Directors effective with the annual meeting on the 14th of April 2022 for a period of two years. Vote for a total of four positions only (co-social counts as one). If you are unable to attend the Annual Meeting, please mail this proxy to the pool’s P.O Box shown above by April 5th. *
Required
Write-In Candidate for New Board Member - only use this section if you chose only three candidates above.
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