Newfield Membership Application Form
All information is required, except as noted. |
| Primary contact |
| Last/Family Name |
(Note: We will use your family name to identify your application.)
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| First Name |
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Middle name/initial
(optional) |
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| Gender |
MF |
| Birthdate |
/ / |
| Contact Information |
| Street Address |
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| City |
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| State |
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| Zip |
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Phone number,
including area code |
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| Email address |
This is important. We will communicate with you primarily via email. |
| Type your Email address again |
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| Membership Category |
Family
Single
Senior
Under-30
(Proof of age required for Senior and Under-30 memberships.)
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| For each family member, please provide the following information: |
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| Interests |
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| Signature |
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I hereby apply for membership in the Newfield Swim Club, Inc., together with the above-listed members of my immediate family,
who are related to me as described above (including children under the age of 26 years), and who are residing in my household
as their actual full-time residence. I understand and agree to the conditions and terms of payment for Membership and Fees
indicated in the Newfield By Laws, which may be amended without prior notice to me.
Please sign this electronic application by typing in your name in the space provided below.
If the BOND is to be issued in the name of two adult family members (e.g., husband and wife), both must sign the Application.
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