2021 Meadow Lane Park Association Membership Application

Meadow Lane Park Association Membership App 2022

This application is for New and Returning members and includes an online payment option.
Primary Member *

First Name Last Name
Primary Member Birthdate *

Month Day Year
Primary Member Email *
example@example.com
Phone Number *

Area Code Phone Number
Member Spouse

First Name Last Name
Member Spouse Birthdate

Month Day Year
Member Spouse Email
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
NAMES PROVIDED BELOW WILL BE USED TO AUTO-GENERATE MEMBERSHIP CARDS. New 2022 Cards are required for entry into the pool. Please list all swimmers, and double check your spelling so that accurate cards may be generated. Upon form submission, cards will be emailed as PDF files to the Primary Member Email provided above. Save cards to your phone or print to scan for entry into the pool.

** If anyone fabricates memberships in any way, you will be asked to pay the correct fee(s). If payment is neglected your membership will be revoked.
Membership Card #1 *

First Name Last Name
Member 1 Birthday *

Month Day Year
Membership Card #2

First Name Last Name
Member 2 Birthday

Month Day Year
Membership Card #3

First Name Last Name
Member 3 Birthday

Month Day Year
Membership Card #4

First Name Last Name
Member 4 Birthday

Month Day Year
Membership Card #5

First Name Last Name
Member 5 Birthday

Month Day Year
Membership Card #6

First Name Last Name
Member 6 Birthday

Month Day Year
Membership Card #7

First Name Last Name
Member 7 Birthday

Month Day Year
Membership Card #8

First Name Last Name
Member 8 Birthday

Month Day Year
Membership Card #9

First Name Last Name
Member 9 Birthday

Month Day Year
Membership Card #10

First Name Last Name
Member 10 Birthday

Month Day Year

Membership Payment Options: *

Membership Options

New Member Fee $ 150.00

Required for ALL new Memberships

Family Membership $ 275.00

2 household adults + up to 5 resident children. Add on available for those not living in same home.

Grandparents Membership $ 275.00

2 household grandparents + up to 5 grandchildren. Add on available for additional grandchildren.

Senior Membership $ 150.00

1 or 2 household adults - All Members on this must be age 62 & over

Single Person Membership $ 150.00

Designed for single member, or use with Single Add On Rider for 1 parent/1 child family.

Single Add On Rider - add a person to your membership $ 85.00

Allows for an additional member to be added onto any membership such as a day care child or provider, frequent guest, or an additional grandchild on Grandparents Membership. Add on does NOT have to be family.

Additional Members

Donations

Help Cover PayPal Fees $ 5.00

Donation $ 10.00

Please help our Concessions get started for the season!

Donation $ 20.00

Donation $ 50.00

Choose Your Own Donation Amount $ 1.00

Donation Amount

Enter coupon

Total $ 0.00

Please note that all purchases/donations are final, as we are unable to process refunds at this time. Thank you and see you at the pool!
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Meadow Lane Park Association Membership App 2022