It's easy to become a member of the
HILLSIDE AQUATIC CLUB
Simply fill in the information requested below.
When finished click on the 'Submit' button.
We will then mail you an invoice.
Membership Name :
Address :
City :
State : Zip :
Home Phone :
Work Phone :
Cell Phone :
Email Address :
Emergency Contact Name :
Emergency Phone Number :
Membership Type Desired :
1 -
2 -
3 -
4 -
5 -
6 -
7 -
8 -
First Name
Nanny or Babysitter
(see note below)
Relationship Birth Date Medical Condition / Allergies
*Single - $295.00/yr. by check or $305.00/yr. by credit card (PayPal)
*Family - $395.00/yr. by check or $405.00/yr. by credit card (PayPal)
* ( New Members Only : There is a one time 'application fee' of $200.00 in addition to the membership fee).
NOTE : If you register a 'Nanny' or 'Babysitter',
there is a fee of $100.00
( in addition to your membership and application cost )
Please supply the information below for each person joining under this membership :
Pay with PayPal
Tell us how you
heard about
Hillside Aquatic
