2022 Summer Break Swim Club Memberships

Summer Break Swim Club Memberships
Summer Break 2022 General Information

Membership Fees (1/1/22-7/15/22) Membership Fees (after 7/15/22)

$125 PER PERSON first 4 members $100 PER PERSON first 4 members

$50 each additional person $50 each additional person

Please note the following:

* Children age 0-2 are FREE and must still be listed on the membership.

* Primary member MUST be 18 years of age or older. NO MINORS can have an individual membership.

* Guest Passes: 5 single use guest passes are INCLUDED with each family membership before 7/15/22. Additional guest passes can be purchased (in advance on this form or at the door) for $5 (only valid for 2022).

* Guests MUST be accompanied by a member at all times.

* Membership cards and guest passes are not mailed. Cards are picked up at the pool front desk your first visit. Please bring photo ID for pick up.
Primary Member (over age 18) *

First Name Last Name
Age as of May 28 Relationship to the Primary Member
2nd Member (Adult or child)

First Name Last Name
Age as of May 28 Relationship to Primary Member
3rd Member

First Name Last Name
*

Age as of May 28 Relationship to Primary Member
4th Member

First Name Last Name
*

Age as of May 28 Relationship to Primary Member
5th Member

First Name Last Name
*

Age as of May 28 Relationship to Primary Member
6th Member

First Name Last Name
*

Age as of May 28 Relationship to Primary Member
7th Member

First Name Last Name
*

Age as of May 28 Relationship to Primary Member
8th Member

First Name Last Name
*

Age as of May 28 Relationship to Primary Member
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email *
example@example.com
Phone Number *
Please enter a valid phone number.

Pool Rules, Rock Wall Waiver, Covid Waiver

My Products *

Membership (Ages 3+) ($125 for people #1-#4, then $50 for person #5+)

$ 125.00 Quantity

FREE Child Member (age: infant, 1, 2)

Free Quantity

Additional Guest Punch Card- includes 5 guests

$ 25.00 Quantity

Subtotal

$ 0.00

Shipping

$ 0.00

Total

$ 0.00

Credit Card

I, the undersigned and all family members listed on this form, acknowledge and understand that NO REFUNDS will be given. Each member MUST present a Membership Card and photo ID for entry. Membership Cards are not transferable and may only be used by the member. Summer Break is not responsible for lost or stolen items.
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