Membership Change Request for Hideaway Swim Club

Hideaway Swim Club

Membership Change Request
Form*
Account Number*
Primary Membership E-mail*
Member Name*

First NameLast Name
Change of Primary Membership Email (listed above)Change of AddressChange of Phone NumberAdd Email AddressAdd Person(s) to your MembershipRemove Person(s) from your Membership
New Address

Street Address

Street Address Line 2

CityState

Zip Code
New Phone Number
Format: (000) 000-0000.
Additional Email Addresses (for our mailing list - general club communications).
Add Children (dependents living at your residence born after 1995)
Add Adult Resident(s) (living at your residence born before 1996)
Add House Guest(s) (must be living at your residence)
Yes
Note: You may not remove a Bondholder from your membership. Only children, adult residents, housequests, and sitter may be removed from your membership.
Person(s) to Remove from Membership
Comments
Signature*
Verification*
Should be Empty: