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CHABOT SWIM CLUB MEMBERSHIP NUMBER

#___________

 (PLEASE PRINT IN ALL CAPITAL LETTERS)

ADULT MEMBER #1 (PRIMARY)

ADULT MEMBER #2 (SECONDARY)

ADULT MEMBER #3 (ADD’L FAMILY)

ADULT MEMBER #4 (ADD’L FAMILY)

ADDRESS:

PHONE NO.

PLEASE NOTE ANY ADULT ON MEMBERSHIP CAN CANCEL THE MEMBERSHIP AND RECEIVE THE REFUNDABLE DEPOSIT

THEREFORE, IT IS RECOMMENDED THAT BABYSITTERS, NANNIES, ETC. NOT BE LISTED AS A MEMBER

CHILDREN LISTED ON MEMBERSHIP

DATE OF BIRTH = TWO DIGIT DAY, THREE LETTER MONTH, TWO DIGIT YEAR

(EXAMPLE 01/JAN/12)

MINIMUM AGE FOR A CHILD TO BRING A GUEST IS 14 YRS OLD (UP TO TWO GUESTS PER CHILD VIA GUEST PASS)

CHILD’S NAME

DATE OF BIRTH

CHILD’S NAME

DATE OF BIRTH

CHILD’S NAME

DATE OF BIRTH

CHILD’S NAME

DATE OF BIRTH

CHILD’S NAME

DATE OF BIRTH

CHILD’S NAME

DATE OF BIRTH

Dated: _______    Member Signature: _____________________

PLEASE RETURN THIS FORM:  VIA EMAIL TO BOARDMEMBERS@CHABOTSWIMCLUB.ORG

 

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Do you need to update your membership information? Click on the link below, fill out the form and email it to boardmembers@chabotswimclub.org
 
 
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