Application for 2020 Tri-Acres Membership
Thank you for choosing Tri-Acres! Please fill out and submit this form. Once your application is approved by the board, we will contact you regarding payment. You may choose to mail a check or have an invoice email to you at an extra 3% charge.
Email address *
I am a *
I was referred by, or found out about Tri-Acres by: *
What type of membership are you applying for? *
Please list the last name of the household *
Please take picture of your license and email/upload to *
Please list the first names of people ages 18 and older (Parents and adult children), who will be listed on your membership *
Per membership rules, a family membership may consist only of the people living in the same household. I.D. may need to be presented.
Applicant Employed by: *
Please list the names and ages of people under the age of 18, as of June 1, who will be on your membership. *
Per membership rules a family membership may consist only of the people living in the same household.
Street address *
City *
Zip Code *
What is a good phone number for us to reach you? *
Tri Acres will be using the Remind app to let all members know about upcoming events, parties, or any issues we may be having. Would you like to be signed up and notified via text message about happenings at Tri Acres Swim? *
To which email address(es) would you like your pool notifications to be sent? *
Tri Acres Rules & Regulations *
Please check off to make sure you have read the rules and regulations section. Tri-Acre's first priority is to make sure that everyone is safe while at the pool. Thank you!
CDC (Center for Disease Control) Regulations *
Please check off after reading each regulation. Thank you.
Please re-type the following statement and add your name at the end, agreeing to abide by our pool rules: "Yes, I have read and understand the above rules and regulations. It is my responsibility to ensure that all my family members and guests are aware of these rules prior to entering the pool. Signed, [your name typed below] *
I am aware that during the swim season, there may be periods of operation time at Tri-Acres Swim Club that lifeguards will not be on duty. During these times, no child (anyone under 18 years of age) will be allowed on the premises without a parent or legal guardian present. I understand the rules and regulations of the pool and know that I am held responsible for the safety and well-being of my family members and guests at all times while at Tri-Acres Swim Club. *
I am aware that there is a telephone available at the sign-in desk by the concession stand should an emergency arise. I know to dial 911 for an emergency, then notify a board member for further assistance. Safety equipment (flotation device) is located at either end of the swimming pool. A first aid kit is located in the office on the shelf above the sink if needed. Names of family member have been listed on this application. *
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my family, including child(ren), and I may be exposed to or infected by COVID-19 while on site at the pool and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the pool may result from the actions, omissions, or negligence of myself and others, including, but not limited to, the HOA Board and pool management company’s employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I, my family and my child(ren) may experience or incur in connection with my child(ren)’s attendance at the pool or participation in pool activities (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the HOA Board and the pool management company and their employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the HOA Board and the pool management company and their employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in pool facility activities. *
Our proposed operation hours are: Sun, Mon, Tue, and Thur-9:30am-8:30 pm. Wed-1:00pm-8:30 pm. Fri, and Sat-9:30am-9:00pm. Although the pool will not be open until 1pm on Wednesday, the rest of the week we will be open earlier in the mornings and later in the evenings! *
GUESTS. I am aware that the cost to bring a guest is $5.00 per guest, and that I may bring up to 5 guests per day. This fee must be paid at entry and will be monitored. I 'm also aware that any member may purchase a guest pass for $40.00, good for ten guest visits. I will list guest names next to my family's name on the sign in sheet located at the entrance desk. Any guests who live more than 20 miles away are free with identification. *
Would you like to add a guest card now to your 2020 dues? *
I am aware that any member may reserve the shelter for three hours for a fee of $50.00. This reservation includes a party, lifeguard, use of grill, and grill tools, plus ten guest passes. *
Members will be given a code for the keyless entry system, once this application is complete, and I have paid my membership in full (or am on a drafted payment plan). I agree not to give my code to anyone who is not listed on my membership. If your gate code is shared your membership can be revoked. *
I am aware that Tri Acres hosts many events for members, throughout the summer, such as an end of the school year party, 4th of July cookout, movie nights, and back to school bash. I am invited to attend! These events will be posted on the members only Facebook page, and also be sent in emails. *
These are added fundraisers to contribute to the cost of maintaining and making improvements to our pool.
I am aware that Tri Acres strives to not only maintain, but improve our pool environment. It costs $30,000 plus yearly to maintain our pool. Tri Acres is run by a board made up of volunteers who meet periodically to review the budget, plan events, and make improvements. I am willing to contribute my ideas, resources, and skills by attending an annual meeting at the pool, and by volunteering when I am available. *
We are asking at least one member from each family volunteer to help, either at the pre-(or post season workdays, or for an event. There is no job too small. If you know you will not have time to help at all, please kindly add $25 to your dues ($15 for couples, $10 for singles). There are lots of fun and easy ways to help out, so please consider paying the lesser amount! Closer to spring, we will have a list of opportunities. *
I will pay my membership fee by: *
Prices are listed above, at the top of form.
I am aware our concession stand accepts cash, check, and debit/credit card. A $25.00 concession card may be purchased to be used like cash when buying any concession items. *
Would you like to purchase a guest pass or Concession card now and add it to your summer dues? *
I understand that violating any of the above rules can cause the revocation of my membership without refund at any given time. *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy