Amenity Access Request Form and Waiver

Amenity Access Request Form and Waiver

Pool, Clubhouse, Gym, etc.
Request Form

Complete both sections if requesting a new key / fob and ONLY the Waiver section if just acknowledging the current Amenity Rules.
Community Name
Community Address
Name of Requestor

First NameLast Name
Owner or Tenant

OwnerTenant
Number of Key(s), Fob(s), Access Device(s), etc.
Typically up to two is allowed for each address
Email
example@example.com
Phone Number
Please enter a valid phone number.
Name of Authorized Key User #1

First NameLast Name
Name of Authorized Key User #1

First NameLast Name
If the current or previous Owner(s) have received an access card prior, they may be an additional fee associated with a newly activated card, please review the Rules and Regulations for fee information.

*PLEASE NOTE: We will accept a personal check or a One Time eCheck Payment through Alliance Bank Online. Please make the check payable to: “{communityName}”. Payment must be made and processed before key(s) is/are issued.

By requesting access to the {communityName} you are agreeing to abide by all of the posted rules for use of the pool. Furthermore, you verify that you have signed and returned the {communityName} Acknowledgement and Waiver.
Signature

Clear
Date

DayMonthYear
Date
Acknowledgement and Waiver
The undersigned hereby acknowledges that he/she has received and reviewed the {communityName} current Rules and Regulations and does hereby acknowledge and affirmatively agree to be bound by the Rules and Regulations and to use the Association Amenities pursuant to and in accordance with the Rules and Regulations for members and guests.

The undersigned affirmatively acknowledges that use of the Association Amenities is at his/her own risk.

In consideration of use of the Association Amenities all residents/individuals/guests who have access to the pool area agree to indemnify, defend and hold harmless the {communityName}, Board of Directors, and management company from any and all claims of any nature.

With the intent to be legally bound by the terms of this document, the undersigned does hereby set forth his/her signature.
Signature

Clear
Date

DayMonthYear
Date
Printed Name

First NameLast Name
Address
Should be Empty:

Amenity Access Request Form and Waiver

Request Form

Acknowledgement and Waiver