SUM Pool Card Waiver Form

Are you an Owner or Renter?*

OwnerRenter/Tenant (All rental properties need permission from the owner in order to use the pool. Please forward the Owner/Tenant Pool Card Permission Form linked below to your landlord).

If you are a Renter/Tenant...

Copy and paste the Owner/Tenant Pool Card Permission Form link below and send to your landlord or property manager. They need to fill out this form prior to pool card activation.

https://form.jotform.com/221515809675058

Please Check only one*

I am a homeowner, and I need ADDITIONAL CARDS ( $-PAY BELOW)I am a homeowner, and I have LOST my original card and need a new one. ($ PAY BELOW)I am a NEW homeowner, and I have a BRAND NEW CARD REQUEST (This option is free for first time requests only).I am a HOMEOWNER, and I have a DAMAGED card that needs to be replaced. (This option is free).I am a HOMEOWNER, and I need a card I have in my possession ACTIVATED. Please type the CARD NUMBER in the space below. (This option is free).I AM A TENANT, and I need a card. I will forward the Owner/Tenant Permission Form ABOVE to my landlord. ($ PAY BELOW)I AM A TENANT, and I have a card I need to activate. I will forward the Owner/Tenant Permission Form ABOVE to my landlord. TYPE THE CARD NUMBER IN THE SECTION BELOW. (This option is free.)

Full Name*

First NameLast Name

E-mail*

example@example.com

Mailing Address the new card will be sent too*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Unit Address of the property in Summerfield HOA (Address, City, State)*

This may be the same as the Mailing Address

Additional Message:

Card Number To Be Activated or Replaced, left by Previous Owner- first 4-5 digits are sufficient.

Upload photo of your card number here if needed

Summerfield Rules and Right to Use

The Summerfield HOA Swim Center will be open from 6 A.M. to 9 P.M. weekdays, 9AM to 10PM Friday-Sunday for swimming on days during the "swim season" as determined by the Board of Directors of the Association.

During the "swim season" no lifeguards will be on duty and all swimmers will swim at their own risk.

The HOA pool and related facilities shall be used only by members of the Summerfield HOA in good standing and their guests and all use shall be only in accordance with pool policies, regulations and rules adopted by the Association's Board of Directors; and each household using the Summerfield HOA Swim Center must have this application and waiver on file with the Association and must possess an entry key authorizing the member and their family and guests to access the swim center during the pool hours set by the Association and Ascension Property Mgmt.

Any violation of the pool rules and regulations established by the Association will result in the termination of that person's right to access the Summerfield Swim Center for the reminder of the swim season as determined by the Association's Board of Directors.

In consideration of the right to use and access the Summerfield HOA Swim Center during the swim season as defined herein, the undersigned desires and agrees to be bound by all provisions of the Summerfield HOA pool use policies, rules and regulations as adopted by the Board of Directors of the Association.

The undersigned on behalf of myself and all family members listed herein who may use the Summerfield HOA pool and related amenities hereby releases and discharges Summerfield Homeowners Association, Inc. ("Association"), its officers, directors and members, and Ascension Property Management (“Manager”) and will hold the same harmless and indemnify them from all claims and liabilities related to our use of the Summerfield HOA pool, or any related amenities

I have read and I understand all pool rules located on the Summerfield76574.org website and posted at the pool

PLEASE NOTE: Pool cards are processed Monday-Thursday from 10 AM- 3PM during the pool season. After the request is processed, they are put in the mail on the next business day. Pick up or delivery is not available. Your card will be sent in the mail.

Term and Conditions*

I agree to all the terms and conditions listed above

Signature*

Payment Notice

Before submiting your form you must pay any/all necessary fees so that we can process your request TO OBTAIN YOUR CARDS. Cards will not be processed without complete payment upfront. If this is a NEW HOMEOWNER request you can skip this step and proceed to the SUBMIT buttom

Check the box below only if you intend to make a payment for a pool card

Summerfield Pool CardSummerfield Pool Card

$26.41 Quantity

Total

$0.00

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