Shareholder Invoice 2024 Form

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THE BOARD HAS APPROVED A $30.00 LATE FEE FOR DUES NOT PAID BY March 11.

Email *

What is your full name? *

PAYMENT - Check must be sent by 3/11/24 to:

Rita Cameron, 4 Spencer Street, Lexington, MA 02420

Payment mailed: check for $995.00 payable to the Pleasant Brook Pool Corporation for the 2024 maintenance fee.

Payment mailed: check for $225.00 payable to Pleasant Brook Pool Corporation for the 2024 sustaining fee. My family will not be using the pool this summer.

Contact Information Name, Address, Phone number *

Email Addresses for Updates *

Children (18 and under) and ages: *

It is expressly agreed that undersigned, as members of the Pleasant Brook Pool Association, their minor children and wards, and non-member users, their minor children and wards, and their guests (hereinafter individually referred to as the “User” and collectively as the “Users”), assume all risks related to the use of the Pleasant Brook Pool Association facilities, including but not limited to any and all risks involved with use of and/or presence at the swimming pool, pool deck, picnic area, playing field and pool house. The Users hereby agree to abide by the Pleasant Street Pool Rules, hereto included by reference.The undersigned User hereby releases, waives, discharges and covenants not to sue Pleasant Brook Pool Corporation, Inc., its directors, officers, servants, agents and employees, interns, and volunteers (hereinafter referred to as “Releasees”) from or for any and all liability, claims, demands, actions and causes of action whatsoever arising out of or relating to any loss, damage, cost, expense or injury, including death, that may be sustained by the User and/or any guests of the User, or to any property belonging to the User or any guest of the User, in connection with the use of and presence at Pleasant Brook Pool Association facilities (the “Pool”). The User voluntarily assumes full responsibility for any risks of loss, property damage or bodily injury, including death, which may be sustained by the User and/or the User’s guests, or any loss or damage to property owned by the User and/or the User’s guests, in connection with the Pool, including but not limited to any injuries, illnesses or bodily harm related to the Covid-19 pandemic. The User further hereby agrees to indemnify and save and hold harmless the Releasees and each of them, from any claims, losses, liabilities (including reasonable attorneys' fees and amounts paid in settlement of any claim), damages, or costs they may incur arising out of or in connection with the User or any guest of the User’s actions or conduct in connection with the Pool, or resulting in any way from any act or omission of the Releasees in connection with the Pool. My signature below confirms all household members who are 18 years old or older have read this Waiver of Claim and the Pleasant Brook Pool Association rules and agree to abide by them. Please type your full name and date confirming this. *

WEBSITE PHOTOGRAPHIC PERMISSION* *

I hereby authorize the Pleasant Brook Pool to post photographs of me and/or my minor children on its website. I understand that I may revoke this authorization at any time by giving written notice to the President of the pool, and when I revoke my release, any photographs of me or my minor children that have been posted on the website will be removed within a reasonable amount of time. I release the Pleasant Brook Pool Corporation and its officers and directors from any claims that might arise from the posting of my photograph on the website.:

I prefer that photographs of me and/or my minor children not be posted on the website of the Pleasant Brook Pool.

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