Seasonal Pool Beach Pass

Seasonal Pool/Beach Pass
Non HVL Resident
Babysitter/Child Care Provider

- A deeded HVL resident must be present with a childcare provider when issuing pass.
- Deeded HVL resident and pass holder must complete and sign application.
- Pass will only be valid from opening date to closing date of pool/beach for current year.
- Cost of the pool/beach pass for season is $50.00.
- POA account must be paid in full.

Deeded HVL Resident Name

First Name Last Name

Address

Street Address

Lot Number

Phone Number

Area Code Phone Number

Work Phone Number

Area Code Phone Number

Cell Phone Number

Area Code Phone Number

Email

example@example.com

Signature

Clear

Waiver & Release: I understand that use of the HVL Pool & Beach Is entirely at my discretion, that I will abide by all the rules and policies of the Hidden Valley Lake Property Owners Association and that I do hereby hold harmless the HVL POA and its employees for any injury which may result from myself or my family’s participation.

Name of Pass Holder

First Name Last Name

Signature of Pass Holder

Clear

Phone Number of Pass Holder

Area Code Phone Number

(MAKE CHECKS PAYABLE TO HVL POA)

or click below to pay by credit card https://hiddenvalleylakeindiana.com/product/pay-your-bill/