2019 REAMSTOWN POOL
MEMBERSHIP APPLICATION
Please follow the steps below.

 *Required.


 

 STEP #1 - PERSONAL INFORMATION: Person filling out application.

First and Last Name*

Address*

City*               State*       Zip Code*
      
Phone*

Email*


STEP #2 - MEMBERS: Up to five (5) members.

(1) Member - First and Last Name:
   
    Relationship to the Name in Step #1:
    
    Age:              Swim Level:
       
(2) Member - First and Last Name:
    
    Relationship to the Name in Step #1:
    
    Age:              Swim Level:
      
(3) Member - First and Last Name:
    
    Relationship to the Name in Step #1:
    
    Age:              Swim Level:
      
(4) Member - First and Last Name:
    
    Relationship to the Name in Step #1:
    
    Age:              Swim Level:
      
(5) Member - First and Last Name:
    
    Relationship to the Name in Step #1:
    
    Age:              Swim Level:
      


STEP #3 - EMERGENCY CONTACTS:  Please list at least one emergency contact.
  
  

 
 
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