Caregiver Registration
If your household has a caregiver who is in need of access to the Facilities in the homeowner’s absence, you are allotted an access card exclusive to the caregiver. Each household can receive a maximum of one caregiver access card. The caregiver must be an adult (18 years of age or older) and is only permitted access to the Pool Facilities when overseeing the client. Any violation of this permission can result in the deactivation and surrender of the caregiver’s access card. In addition to the homeowner, the caregiver must sign our Facilities Use Agreement and pay a fee of $30.
Caregiver Name
*
First Name
Last Name
Caregiver Email
*
example@example.com
Caregiver Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Caregiver Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Back
Next
Inspiration Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
blanks
is the Care Giver for
blank
*
.
Upload a Copy of State Issued Identification for Caregiver
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Back
Next
*
I understand that Facility Use Agreement will need to be signed and the lot owner will need to provide a check for $30 delivered to the Association Office before Mobile Access Credentials will be released to Caregiver.
Caregiver passes are valid from Memorial Day to Labor Day in the same Calendar Year.
I understand that the Caregiver must be at least 18 years of age.
Signature
Caregiver Facility Use Agreement
www.InspirationHOATx.com/CareGiver
Submit
Should be Empty: