Pool Membership

Registration Form

 

Membership type:

A.)Family             Single         Weekend only

 

B.)Summer only           Swim & Tennis             Yearly

 

Last Name _____________________   

 

Family members name/s: ____________         Age _________ M/F___

                                                ____________         Age _________ M/F ___

                                                ____________         Age _________ M/F ___

                                                ____________         Age _________ M/F ___

                                                ____________         Age _________ MF ___

                                                ____________         Age _________ M/F ___

                                                ____________         Age _________ M/F ___

 

Address __________________________ County ________ Zip ______

 

Home Phone # _______________  Business # ___________ Cell # _______________

 

Emergency contact person ____________________________ # _________________

 

Eamil address: __________________________________

 

Allergies or Health conditions of family members:

 

_______________________________________________________

 

_______________________________________________________

 

_______________________________________________________

 

 

I, _____________________________ agree to release Youth Swimming, Inc.,  Walton

Waves, Inc. , Youth Athletic Recreation Company, Inc., & Staff, Bluesprings Sports

Ranch & Staff from any responsibilty for property damage, illness, or injury incurred

by my child at Bluesprings. I also agree to allow Youth Swimming Staff, or another

authority to administer First Aide for my child, if necessary. I, the undersigned, will be

responsible for any & all costs of medical attention and/or treatment.

Signed _________________________Date __________________

 

 

Please make checks payable to :          Crystal Aquatics

                                                                        1810 Kristin's Way

                                                                        Loganville GA 30052

 

If any questions please call 770-466 - 8353