Membership Application

Member Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone *

Home Phone

Email *

Membership Type *

I plan to pay with... *

A credit card on the next page

Member Names

Please list the name, age, and relationship of the others who will part of your membership. Note that all parties on the membership must reside in the same household.

Look, don't be sketchy. If you list 7 adults and 5 kids living in one house, we are going to ask for proof to verify. Acceptable forms of address verification include utility bills, tax returns, and pay stubs.

Name, Age, Relationship to Member

For additional members, please use the comments section at the end.

Have you been a member of Poco before? *

No, this is my first time joining Poco.
Yep, I love Poco and I'm back for more!

Use code new2024 for new member discount!

Emergency Contact *

Emergency Contact Phone *

Should we be aware of any medical conditions?

How did you hear about Poco?

Comments

Membership Terms

All membership options include the use of the pool through September 2, 2024. Swim and Dive team is not included in your membership. In typing my name below and submitting this application, I and the people on my application agree to abide by the rules set forth by Pocahontas Swim Club and enforced by their staff or board members. I understand that if I do not abide by the pool rules, my membership can be revoked with no refund of the membership fee. Memberships cannot be cancelled once the season begins. Refunds may be given with a written notice, minus the processing fees if paid by credit card. I understand that photos of me or members of my family may be included in promotional materials by Pocahontas Swim Club. (But if we put a picture of your kid on our website and you don't like it, just let us know.) The Board of Directors reserves the right to amend the terms of membership at any time to keep the pool safe and enjoyable for members. To complete your membership, after clicking Submit, YOU MUST ADD YOUR MEMBERSHIP TYPE TO THE CART AND CONTINUE TO THE PAYMENT PAGE.

e-Signature *