Larkey Contract and Purchase Agreement

FAMILY NAME*

Last Name

PARENT(S) FIRST NAME(S)*

CHILDREN'S NAMES:*

Please list all children's names.

E-mail*

Main family email address

E-mail

Secondary email address

Phone Number #1*

Main family contact phone #Format: (000) 000-0000.

Phone Number #2

Secondary phone numberFormat: (000) 000-0000.

Address:*

Street Address

Street Address Line 2

CityState

Zip CodeCountry

EMERGENCY CONTACT*

Name and phone #

Please list all allergies

Allergies

I understand that I must pay a one time initiation fee of $450 to Larkey Swim Club as a new member. The club treasurer will invoice you.

I agreeN/A - Splash Member

I understand that annual dues are payable by May 1 of each year. Late fees will incur if received after that date. My family will not have permission to use the pool facilities until our annual dues are paid. Dues subject to change each season. The club treasurer will invoice you.*

I agree

I understand I will have Larkey Care obligations and responsibilities consisting of a total of 4 hours of maintenance work. It is my responsibility to sign up for shifts before the end of the season.*

I agreeI would prefer to opt out of Larkey Care obligations and instead will pay the $325 buyout fee.N/A - I am either a first-year Swim Team "Splash Fee Member" or a "Splash 15 - 18" Member

I understand that financial penalties incur if all obligations are not met and other arrangements or buy-outs were not done. A fees and penalties table is shown on the Membership page of the club's website and I will abide by those parameters.*

I agree

I have read and understand the club's rules and regulations and bylaws (see links on website) and agree to be bound by these bylaws and rules and regulations in all respects during the period of membership; and, if not adhered to, my membership may be terminated by the Board of Directors.*

I agree

I understand the definition of a 'member in good standing' is that the members have paid their dues on time, completed all maintenance requirements and/or paid any buy-outs or fines.*

I agree

SPLASH FEE MEMBERS: I understand that this is available only to first-year swim team families or families who's youngest child on swim team is 15 or older, and that I am only able to use Larkey Private Swim Club facility during swim team practice and swim meets only. I will vacate the premises within 15 minutes after each swim practice and I understand that free swim time is prohibited. I understand that in order to continue swim team membership the following year, I must purchase a fulltime membership from Larkey Private Swim Club at the current price. The club treasurer will invoice you the $200 fee.*

I agreeN/A

If you were referred by a family that are current members, please put their last name below:

By signing below, I verify I understand the above-mentioned information and that all member families need to support all the various activities, responsibilities and obligations listed above and in the club's bylaws, rules and regulations in order to ensure the wellbeing of Larkey Private Swim Club, which is organized solely for the recreation and enjoyment of its members and guests.

ALL ADULT MEMBERS MUST SIGN BELOW.

Signature 1*

All adult members must sign

Signature 2*

All adult members must sign

Date

Today's Date

Larkey Private Swim Club Contract and Purchase Agreement