2009 POOL PASS REGISTRATION
Lake Princeton Homeowners’ Association
HOMEOWNER LAST NAME
(please
print)
___________________________________
ADDRESS _______________________________________
HOME PHONE _____________________
EMERGENCY CONTACT _________________________
PHONE NUMBER __________________
The cost of each pass is $5.00
There is a limit of 4 guest passes per
household.
LIST ALL FAMILY MEMBERS IN THE GRID BELOW
Please include only immediate family members living at the above address.
Check the appropriate box (“Child”, “Teen”, or “Adult”) based on the age the
family member will be on Memorial Day 2009. (Residents that will turn 14 during
the summer will receive a teen pass). You must be present on your HOA fees to
obtain any pool passes. Passes will
be available for pick up at the pool on May 9th and 16th
between 10:00 am and noon.
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Name
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Adult
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Teen
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Child
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Date of birth
If under 16 |
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First and Last |
Over 16 |
14-15 |
0-14 |
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As the adult representative of the above household, I agree to abide by all
rules and policies listed in the Lake Princeton Pool Rules which I will receive
with my pool passes.
I affirm that the information on this registration form is accurate and
acknowledge that falsification will lead to revocation of all family pool
passes.
HOMEOWNER SIGNATURE: X___________________________Date: _________
A waiver for those teens 14-15 year olds must be signed by both parent and teen.
This from must be signed by each teen.
The form must be signed and turned in prior to receiving your pass.
An alternative GUEST PASS WITH TEEN PRIVILEGES (with signed parental consent-see
below) maybe used by adult family members as well as their teenagers.
LAKE PRINCETON RESIDENTS MUST BE
PRESENT AT ALL TIMES WITH INVITED GUESTS.
SPECIAL
HOMEOWNER CONSENT for GUEST PASS WITH TEEN PRIVLEDGES:
I hereby authorize our guest pass to be used by our teenage family member. Each
teenager is entitled to bring up to 2 guests. Each teenage family member must be
present and responsible for the use of this pass. The resident’s TEEN PASS must
be presented along with the GUEST PASS WITH TEEN PRIVLEDGES.
HOMEOWNER SIGNATURE: X_____________________________ Date: __________
You can
mail,fax or drop off the forms to
West Chester Community Administrators
9772 Princeton-Glendale Road
Cincinnati, Ohio
45246
Fax 513-860-3190