Surreywood Swim & Tennis Club Membership Form - 2016
Fill out the information on this page, select request invoice on this form to get an emailed invoice or send in your membership payment via postal mail. Payment can be made in full or in 3 easy payments (by 2/15, 3/15 and 4/15). Memberships are not active until payment in full has been received and membership details have been reviewed and approved.
Billing Name, (Last , First) *
Your answer
Alternative Family Name(s) (if multiple last names)
Your answer
Membership Type *
Select all that apply. For membership type details go to
Member Rates
New Member?
New Member Sign Up Bonus: 4 free guest passes + $10 snack bar credit included! (For members who have not joined the pool in the past 5+ years).
Referring Member
Your answer
Guest, Sitter, and Child Care Passes
For a description of pass types, click:
Friends of the Pool Contribution
Submit a donation to the pool. (Donations of $40+ are invited to FOP appreciation party.)
Payment method *
Payment in full is required for active membership. If using an installment plan, add a $15 one time processing fee and make three equal payments due on 2/15, 3/15 and 4/15. *** Select request invoice or send in your membership payment via postal mail to PO Box 74303, North Chesterfield, VA 23225 or placed in Drop Box at 7753 Lake Forest Drive, N. Chesterfield, VA 23235
Installment Amount
If using and installment plan, please enter the installment payment amount:
Your answer
Name(s) of Sitter, Child Care or Sponsored Individual
Your answer
Member Names and Birthdates *
Enter all members (including yourself) requiring access to the pool by name (One name per line)
Your answer
Address *
Specify your physical residence address
Your answer
Primary Phone Number *
Enter your Home or Mobile Phone number and specify phone type
Your answer
Alternate Number
Specify phone number and type (mobile, home, etc)
Your answer
E-mail *
Your answer
Would you like to receive the pool newsletter? *
How did you hear about us?
Are you interested in volunteering?
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