Contact Information: (person to contact if any questions)
Name
Street Address
City
State
Zip
Your e-mail
Phone
Cell Phone
Membership Information:
Were you a member
last year?
Yes
No
Membership Number
Number of people in Household
Cameo Resident :
Yes
No
Membership Fee: (check the box next to the membership that applies to you)
Cameo area Family Membership:
$400
Non-Cameo area Family Membership:
$450
Senior Membership (55 and older):
$125
Emergency Contact Information:
Family Physician
Phone Number
1st Emergency Contact
Phone Number
2nd Emergency Contact
Phone Number
Please download, read, print and sign the
Pool rules and Assumption of risk (2 Page PDF)
and submit with your application.
Applications that do not include signed copies of the Pool Rules and Risk Assumption forms will be returned to the requesting family