Darley Swim Club Member Form
Membership Form for Darley Swim Club Members - If paying by Paypal you MUST send as to a friend and NOT for goods and services and add a $5 service fee.  Thank you!
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Are you a new member or a returning member? *
How many people are included on your membership? (NOTE: dues prices listed are for NEW MEMBERS ONLY and include a $50 discount)  Returning members please refer to your dues statements you received for correct amount. *
Required
Do you have a Non-Family Affiliates (a grandparent or babysitter) to add so they can watch your children at the pool?  (MAX of 2)  Please provide their Name and note if they are grandparent or sitter.  Add $110 to your dues for each NFA. *
What is your Family's Last Name? *
What is your First Name (you are 1st Member on membership)?  *
What is your Spouse's Name or whoever will be the second listed on your membership, include date of birth if under 18? (2nd Member)
Please list your 3rd Member and include their date of birth if they are under 18 (if applicable)
Please list your 4th Member and include their date of birth if they are under 18 (if applicable)
Please list your 5th Member and include their date of birth if they are under 18 (if applicable)
Please list your 6th Member and any additional members and include their date of birth if they are under 18 (if applicable)
What is your Address? (Please include City, State and Zip code) *
What is your Phone Number? *
What is your email address? *
What is your Occupation? *
How did you hear about Darley Swim Club? *
This form is for PayPal only, if you would like to write a check and drop it at the pool or pay in cash, please download the form on the website and fill that out. (Please see totals listed above and add in NFA fees and/or maintenance fee plus the $5 paypal service fee) *
By paying dues and becoming a member of the Darley Swim Club , we agree to abide by the rules and comply with all terms set forth in the Darley Swim Club By-Laws.  A copy of the rules and by-laws can be obtained online at www.darleyswimclub.com.    *
Paypal Payments:  Please make sure to send as to a friend and NOT for goods and services.  If you send for goods and services and we need to refund you there will be an additional $5 charge for refunding as Paypal charges us fees for this.  Thank you for understanding!
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