2023 Kings Point Pool Registration Form

Kings Point Recreation Club (Kings Point Pool) Registration

Complete the form below to sign up for the 2023 pool passes
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 pass holderGoogleSocial MediaReferred by friend/existing pass holder

Pool Access - Please write all information below for all people in your household covered in the pool pass (kids & adults included. Also, 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 - enter N/A for empty fields.

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

Health - Please list name and any relevant health concerns below for each person on your annual pool pass:

In Case of Emergency:*

	Name	Phone Number	Address	Relationship to Pass Holder
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.

Pool Rules
I have read, understood, and accepted*

The Code of Conduct, Pool & Facilities Rules
Waiver and Release of Liability
I have read, understood, and accepted*

The Waiver and Release of Liability policy.
The emergency contact information contained within this policy has been provided above.

Signature*

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

Should be Empty:

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Kings Point Recreation Club (Kings Point Pool) Registration

What are the "resident" boundaries?

Pool Rules

Waiver and Release of Liability