2020 New Member/Current Member Application

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This is for new members just joining. If you are looking for returning member dues, see the make a payment tab.

Instructions: Please complete in full the following application. Make payment/s to Nassau Swim Club either by mailing a check to P.O. Box 6, Yorktown, IN, 47396 or click the link here to pay via PayPal (*Additional Fees will apply). If you have any questions please contact us via e-mail at nassauswimcluborganization@gmail.com .

Email *

New Member please choose your option: *

Full stock owning, voting privileges membership (total $875)

Non-voting membership (total $600)

Other:

Returning Members please choose your option: *

Active Family Membership (due April 1) $400

Active Single/Senior membership (due April 1) $350

Inactive Member (due April 1) $35 per year until you wish to cancel or go active

Applicant First Name *

Applicant Last Name *

Mailing Address *

Spouse First and Last Name (if applicable)

Names and birth dates of children living with you

Primary Phone *

Secondary Phone

Babysitter and/or Grandparent name ($25 for a summer pass)

Payment method *

I will be mailing a check to Nassau Swim Club at PO Box 6, Yorktown, IN 47396

I will be paying right now via PayPal on the link provided on the website

Electronic Signature

A copy of your responses will be emailed to the address you provided.

Submit

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