Lake Park, NC

A Community For All Seasons

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Pool Membership Application

ONLINE FILLABLE POOL APPLICATION
First Name:
Last Name:
Address:
City/State, Zip:
Cell Phone Number:
*E-mail Address:
*Membership Category:
Individual- Resident ($172)
Couple - Resident ($246)
Adult/ One Child - Resident ($246)
Adult/ Two Children - Resident ($293)
Family- Resident ($327)
Senior Individual (55-74)- Resident ($119)
Senior Couple (55 & over) - Resident ($212)
Silver Senior (75+) - Resident
Individual- NON Resident ($247)
Couple - Non Resident ($327)
Adult/ One Child - Non Resident ($327)
Adult/ Two Children - Non Resident ($355)
Family- Non Resident ($402)
Senior Individual (55-74)- Non Resident ($132)
Senior Couple (55 & over) - Non Resident ($246)
Silver Senior (75+) - NON Resident ($35)
Additional Members / Age/ Birth Date:
Emergency Contact Name:
Emergency Contact Phone:


* - denotes required field
Village of Lake Park, NC