2009 - Pool Tag Form

Number of tags: ___________________ (Equal to number of residents age 12 and up, listed below)

CLAREMONT PARK HOMEOWNERS ASSOCIATION, INC. POOL TAG REGISTRATION FORM 2009 POOL SEASON Upon acceptance of this membership card to the pool, I/WE agree to be responsible for the acts and omissions of all those persons who enter the pool area, and agree to hold harmless and indemnify Claremont Park Homeowners Association, its agents, employees, directors, officers, contractors and members from all claims arising from or connected with the use of the pool area and arising from entry achieved through the use of the card or entry to the pool area with MY/OUR consent authority. I understand that children between the ages of five (5) and twelve (12) must be accompanied and adequately supervised by an adult at all times in the pool area. All children under the age of (five) 5 must be supervised by an adult at all times in the pool area. I/WE have read and understand the above rules and regulations. I/WE agree as an owner in common to support the safe and proper operation of the pool in accordance with those rules and regulations. ________________________________________ Resident (Printed name)

_______________________ Date

________________________________________ Address

_______________________ Home Phone Number

________________________________________ Resident Signature

_______________________ Email Address*

*Would you like to receive emails notifying you of Claremont events/news? _____Y _____N

Name of Each Family Member:

Date of Birth

Age

Tag Number

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