2017 Membership Invoice and Agreement Form - Annual Payment

  • This agreement made between Lakemont Swim Club Inc, a North Carolina non-profit corporation (hereinafter referred to as the "Club") and the Member of Record as listed below. All members shall abide by the Lakemont Club By Laws and Handbook as set forth at www.lakemontpool.com.

  • 1. Membership Fees
    The Member of Record agrees to pay the Club's 2017 annual dues as set forth below upon the signing of this agreement as well as the Club's annual dues as the Club's Board of Directors establishes each year which shall be payable and due by May 1st of each subsequent year of membership thereafter. Any failure to pay annual dues shall, at the sole discretion of the Board of Directors, result in immediate cancellation of the non‐paying Member's membership.

  • Please select one of the membership types below. The 2017 Annual Membership dues will be made in on annual payment due today.
  • If you were a new member in 2016 and opted to defer half of your initiation fees, please check the box below.

  • 2. Member of Record Information
    Applicant Member of Record Contact Information: The Member of Record shall be the voting member and the person of contact for administrative needs. There is only one Member of Record per Membership.

  • Additional Household Members

  • Referral Info
    By naming an existing Lakemont member who most encouraged you to join, the member will be eligible for $50 off of their dues!

  • 3. Lakemont Torpedos Swim Team 2017 Registration

    Registration Fees
    Pre-Swim is for our little swimmers not quite ready for Swim Meets. If you have more than four swimmers, please fill out a paper form and mail it in with payment.

    Finally, please check the one or more boxes below for each of your swimmers.
  • Please enter your swimmer(s) name, age and T-shirt size.
  • Please check any dates your swimmer(s) will not be in attendance.
  • $0.00

  • 4. Parental Consent and Emergency Contact Information Form
    This Emergency Contact form shall be on file with the Club Manager before unattended visitation privileges are granted.

    This consent from is to be signed only after agreeing to all of the following: Children under the age of 10 shall not be permitted on Club property unless accompanied by a person 13 years of age or older. Responsibility of the person accompanying the child to the Club continues while the child remains on Club property. Child Members 10 years of age and older may visit the Club unattended at the discretion of the Pool Manager and Staff.


    EXPECTATIONS CONSEQUENCES
    I understand the following is expected of all children: I agree to the following consequences:
    1. To abide by the Lakemont Club Handbook 1st strike: verbal warning
    2. To follow instructions given by lifeguards 2nd strike: time-out; parents/guardians notified
    3. To be respectful of the membership and staff 3rd strike: removal from club property


    All strikes will be noted in a file and be made available to parents/guardians. In the event the above expectations are continually violated, I understand the Pool Manager reserves the right to revoke said child's privilege of unattended visitations for a time set forth by the Pool Manager. The Pool Manager has full Board authorization to act at his/her discretion. *No child shall be removed from club property without parent/guardian notification.*

  • EMERGENCY CONTACT INFORMATION

  • EMERGENCY MEDICAL INFORMATION

  • PERMITTED UNATTENDED CHILDREN
    The Member of Record requests that the below-named child(ren) be allowed to visit the facility unattended and by signature he/she acknowledges and agrees to the aforesaid terms in their entirety: