Creekside Membership Application
Applicant Information
Name (Primary Applicant): *
Your answer
Street Address: *
Your answer
City: *
Your answer
State: *
Your answer
Zip: *
Your answer
Email: *
Your answer
List ALL family members (including applicant) living in the same household to include in this membership:
Member 1
Member 1 (Primary Applicant): Name
Your answer
Member 1 (Primary Applicant): Date of Birth
MM
/
DD
/
YYYY
Member 2
Member 2: Name
Your answer
Member 2: Date of Birth
MM
/
DD
/
YYYY
Member 2: Relationship to Primary Applicant
Your answer
Member 3
Member 3: Name
Your answer
Member 3: Date of Birth
MM
/
DD
/
YYYY
Member 3: Relationship to Primary Applicant
Your answer
Member 4
Member 4: Name
Your answer
Member 4: Date of Birth
MM
/
DD
/
YYYY
Member 4: Relationship to Primary Applicant
Your answer
Member 5
Member 5: Name
Your answer
Member 5: Date of Birth
MM
/
DD
/
YYYY
Member 5: Relationship to Primary Applicant
Your answer
Member 6
Member 6: Name
Your answer
Member 6: Date of Birth
MM
/
DD
/
YYYY
Member 6: Relationship to Primary Applicant
Your answer
Member 7
Member 7: Name
Your answer
Member 7: Date of Birth
MM
/
DD
/
YYYY
Member 7: Relationship to Primary Applicant
Your answer
Member 8
Member 8: Name
Your answer
Member 8: Date of Birth
MM
/
DD
/
YYYY
Member 8: Relationship to Primary Applicant
Your answer
Membership Type
Your invoice will reflect the membership amount based on how many people in your family join and the type of membership you select.

See full pricing sheet here: https://goo.gl/tKSNi6

Select membership: *
Add-Ons
Select add-ons (optional):
If you selected Daily Guest Pass above, indicate how many 10-packs you want to purchase?
Your answer
One Time Fees to Join
New members are required to pay the following fees as part of the application process:
Bond $200
Initiation Fee $150 ***WAIVED FOR 2018***
Processing Fee $25 ***WAIVED FOR 2018***

TOTAL ONE-TIME FEES: $200

Click here to acknowledge that you understand the fees. *
Required
NPE Family
Do any of your children attend NPE? *
Member Referral
Did a Creekside member refer you? *
If yes, please list their name:
Your answer
Fine Print
- A family membership is limited to family members living in the same household.
- All families must purchase/hold a bond, even for Sessions and Combos.
- The purchaser/holder of the bond must be 18 years or older.
- All fees are included in the above listed rates, EXCEPT for the bond.
- Cost of bond for 2018 = $200/family. This is a one-time fee.
- Families can pay in installments. Please email contact.swimcreekside@gmail.com for more information.
- Pay your bill in full by March 1, 2018 and receive 5% off your bill plus 5 free guest passes.
On behalf of my family listed, I hereby make application for membership to the Creekside Swim Club. I promise to abide by the by-laws, to purchase stock in the corporation including applicable taxes and to pay promptly the annual dues required for active membership. I understand that acceptance of this application will entitle my family to one vote in the affairs of the corporation.
Please enter your name to indicate that you agree with the information provided on this form. An invoice will be mailed to your shortly. *
Your answer
WELCOME TO CREEKSIDE!
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms