RIVER GLEN SWIM CLUB

2017 MEMBERSHIP APPLICATION

 

NAME:____________________________________________________________________________________

 

ADDRESS:_________________________________________________________________________________

 

CITY:_________________________________________STATE:______________________ZIP:_____________

 

HOME PHONE:______________________________BUSINESS/CELL  PHONE:_________________________

 

E-MAIL;____________________________________________________________________________________

 

 

FEES ARE AS FOLLOWS:                                                                

 

            Individual or first household member                                                                 $ 335

            Each additional household member                                                                         80

            Household members are family members who reside in the Individuals home or full time nannies.  All children 1 year old and older are required to have a membership.

            Guest Passes may be purchased at the Pro Shop for $7.

Membership cards will be available for pick-up at the pool on or after May 27th.  

If you are planning a gathering during regular business hours and expect more than 10 attendees, please inform Stephanie at 441-6275 so that we can have adequate staffing.

 

Please note the ages (at 6/01/17) of all children with a swim membership.  Also, print the exact name as it should appear on each membership card.  Thank you!

 

1st  MEMBER NAME                                                                                                                                                           $__________

 

2nd MEMBER NAME                                                                                                                                AGE ______  $__________

 

3rd  MEMBER NAME                                                                                                                                AGE ______  $__________

 

4th  MEMBER NAME                                                                                                                                AGE ______  $__________

 

5th  MEMBER NAME                                                                                                                                AGE ______  $__________

 

6th  MEMBER NAME                                                                                                                                AGE ______  $__________

 

GUEST PASS PURCHASE:                                AMOUNT OF PASSES _________ X $6.00                                     $__________

 

                                                                                                                                                                TOTAL                    $__________

 

 

COMMENTS/SUGGESTIONS:____________________________________________________________________________

 

______________________________________________________________________________________________________

 

______________________________________________________________________________________________________

 

 

 

5CHECK NO:_____________________________ MAKE CHECKS PAYBLE TO:   RIVER GLEN COUNTRY CLUB

Due to increased regulations of credit card usage, River Glen is unable to accept credit card payments via mail.  Credit card payment may be made in person in the Pro Shop.

BY MY SIGNATURE, I INDICATE THAT I UNDERSTAND THE NO REFUND POLICY AND THAT I SHALL ABIDE BY ALL RULES AND REGULATIONS OF THE MANAGEMENT.

 

Signature:______________________________________________________________Date:__________________

 

 

PLEASE RETURN TO:                      RIVER GLEN COUNTRY CLUB, 12010 CLUBHOUSE DRIVE, FISHERS, IN  46038.

QUESTIONS PLEASE CALL:          441-6275