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CHABOT SWIM CLUB MEMBERSHIP NUMBER

#___________

 (PLEASE PRINT IN ALL CAPITAL LETTERS)

ADULT MEMBER #1 (PRIMARY)

ADULT MEMBER #2 (SECONDARY)



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

A DAYCARE PROVIDER CAN NOW BE ADDED AS A SEASONAL HELPER TAKING CHILDREN TO THE POOL. THIS ALLOWS ONE(1) PERSON CARING FOR A MEMBER'S CHILDREN TO COME TO THE POOL WITHOUT A GUEST PASS WHEN ACCOMPANIED WITH MEMBER'S CHILDREN ONLY.  THEY MAY NOT BRING OTHER GUESTS WITH THEM, NOR COME ON THEIR OWN.  

CHILDREN AND ADDITIONAL ADULT LIVING IN THE HOME 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 WITHOUT A PARENT IS 14 YRS OLD (UP TO TWO GUESTS PER CHILD VIA GUEST PASS)

ADULT'S NAME

LIVING IN THE HOME

ADULT'S NAME

SEASONAL DAYCARE

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

 

DOWNLOADABLE DOCUMENTS
 
Do you need to update your membership information? Click on the link below, fill out the form and email it to

boardmembers@chabotswimclub.org

Chabot Swim Club Member Info 2018.docx

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