Kings Point Membership Registration Form

Kings Point Recreation Club (Kings Point Pool) Membership Registration

Complete the form below to sign up for the 2022 membership.
Name*

First NameLast Name
E-mail*
Phone Number:*

Area CodePhone Number
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Birth Date:*

MonthDayYear
Where did you hear about us?

I'm an existing memberGoogleSocial MediaReferred by friend/member

Pool Access - Please write all member information below. Please include any adult(s) (over the age of 16) who will be regularly supervising your children at the pool, such as a nanny or babysitter.

	Full Name	Relationship to Member	Age	Email Address (adults only)	Phone Number
1
2
3
4
5
6
7
8

Health - Please list member name and any relevant health concerns below for each person on your membership:

In Case of Emergency:*

	Name	Phone Number	Address	Relationship to Member
Emergency Contact
Preferred Hospital
General Practitioner

Type a question*

I hereby give my permission for proper medical treatment to be secured (including hospitalization and surgery) for my children and myself, in the event of illness or injury. I certify that I/my children have no medical problems of which I am now aware, except as noted above.

Membership Rules
*

I have read, understood, and accepted the Rules for Membership.I have read, understood and accepted the Kings Point Volunteer Policy
Waiver and Release of Liability
*

I have read, understood, and accepted the Waiver and Release of Liability policy.
*1) The emergency contact information contained within this policy has been provided above OR 2) I am a vested only member and I agree to provide emergency contact information should I, or any of my affiliates visit the pool.
Signature*

Clear
Once you submit your application, we will contact you to process payment and complete your membership application. Thank you!

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Kings Point Recreation Club (Kings Point Pool) Membership Registration

Membership Rules

Waiver and Release of Liability