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Business Mailing Address: P.O. Box 9614, Henrico, VA 23228-0614 Location: 2434 Swartwout Avenue, Henrico, VA
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 I hereby apply for membership in the Lakeside Swim & Racquet Club (aka "LSRC") and understand that this application is for the one person listed below, who will be known as the membership owner. I am aware of, and will faithfully uphold and abide by the purposes, rules, and Bylaws of LSRC, now and as hereafter duly adopted.
I understand that the Board of Directors must approve me for membership as set forth by the LSRC Bylaws. If the LSRC Board of Directors does not accept my application, all money submitted for this membership will be refunded.
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Applicant / Membership Owner Information (please print; all information is required; N/A if not applicable):
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First Name:Last Name:
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Birthdate (mm/dd/yyyy format): / /Email:
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Street Addr:Home Phone:
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City/State/Zip:Cell Phone:
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Emergency Contact: First Name, Last Name & Phone#:How did you learn about joining LSRC?
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Tennis-Only New Membership Dues & Fees, FY2025 Season:
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New Membership Purchase Fee, Tennis-Only Privileges - Initiation Fee$364.00 Tennis Initiation Fee
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New Membership First Year Dues (dues waived for 1st year new membership)$0.00 Renewal dues apply
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New Membership, Facility Improvement Fee$100.00 Per membership
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Total Fees/Dues for New Membership, Tennis-Only Privileges$464.00 Year 1, to join new
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Tennis-Only New Membership, Member Referral Credit:
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LSRC offers a "Member Referral Credit" (a reimbursement check of $100) when any new tennis-only applicant is approved and referred for membership by an active LSRC member. If you have been referred to join LSRC by an active member, you must provide the name of the LSRC referring member in order for the credit to be given to the referring member.
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Enter the name of the LSRC referring member:
Member's Phone#:Member's email or other contact info:
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Member Payment Information:
At least 1/2 of the new membership dues & fees must accompany this application. Installment payments is an option for the remaining balance, and there is no extra cost to pay in installments. If you are interested in the installment payment option, please access the Installment Payments webpage of the LSRC website, www.golsrc.com. Access to the tennis courts will not be granted until full payment has been made to LSRC, no matter the payment method. Payments can be made in the form of a check payable to LSRC, or cash (delivered directly to the Treasurer). You may pay via credit card on the LSRC website as the final step of an online membership application, or may make credit card payments towards online invoices built for your use. Credit card payments require an additional 3% fee. There will be a $30 charge for all returned checks. Please direct other inquiries to the LSRC email address: lsrcpool@gmail.com.
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For LSRC/Treasurer Use:
Amt Received: $____________________ W/A DB Updt:_________
Pay Format: Check# _____________ Cash: __________
Board Approval List: ______________ Email Notified:__________
Applic Copy Posted to DB: _________ Treasurer Initials: ________		AMOUNT PAID BY
APPLICANT: $_____________________

Applicant's Signature:

___________________________________________

Signature Date: ________________________
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