Dock Rack Wait List Form

Dock Rack Wait List Form
Name*
Mailing Address*
Lot Number*
Cell Phone *

Area CodePhone Number
Email*
example@example.com
Please add my name to the following dock waiting list(s):

Pontoon DockSpeedboat Dock
Kayak Rack : # of spaces (You can reserve up to 4 spaces)
Dock space is assigned to property owners in good standing based on previous rental and availability. Pontoon dock space may require a longer wait. If payment is not received from current dock renters, docks will be assigned to those on the waiting list. Kayak racks are part of the Dock Renewal Form that will be sent out.

Dock space will not be held after the announced deadline each year.

Previous dock renters have first priority and have until the announced deadline to reserve their space. We will not know until after that date which spaces may be available. We will contact you!

This form is not valid without POA staff date/time stamp and signature.
Applicant's Signature*

Clear
Date Signed*

MonthDayYear
Date
Below is For Office Use Only
Deed Owner

YesNo
Dues Current?

YesNo
Copy to Resident?
Date

MonthDayYear
Date
Time
Hidden Valley Lake POA 19303 Schmarr Drive, Lawrenceburg, IN 47025 (812) 537-3091 or FAX: (812) 537-1521
Should be Empty:

Below is For Office Use Only