2023 WGRA Membership Application
A copy of this application for membership at the WGRA Pool will be emailed to you upon completion. 
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Email *
Are you a neighborhood resident of Wellington Green or Kingsgate? *
Which best describes you? *
Select 2023 Season Membership Type: *
WGRA now accepts online payment and adds a 4.5% convenience fee as charged from our merchant. If you'd rather pay by check, tally your correct total for payment, and pay as directed when form is submitted. All memberships are pending until payment is received in FULL.

***For the 2023 Early Bird $30 discount, use promo code EARLYBIRD in checkout, no spaces! ***
Required
Would you like to add an Extended Hours Membership?
Primary Member First Name: *
Primary Member Last Name: *
Primary Member Phone: *
Spouse First Name:
Spouse Last Name:
Spouse Email:
Spouse Phone:
Street: *
City: *
Zip: *
Emergency Contact & Phone: *
Dependent 1 Name
Dependent 1 Date of Birth
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DD
/
YYYY
Dependent 2 Name
Dependent 2 Date of Birth
MM
/
DD
/
YYYY
Dependent 3 Name
Dependent 3 Date of Birth
MM
/
DD
/
YYYY
Dependent 4 Name
Dependent 4 Date of Birth
MM
/
DD
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YYYY
Family Caregiver First Name, Last Name, Phone Number
In-Town Guests:  may visit up to five times a season with five dollars per guest pass, not to exceed fifteen dollars per family.  Guest(s) MUST be accompanied by an Adult Member. Residents of the neighborhood do not qualify as guests.  Out of Town Guests:  May visit with no charge. Association Bylaws and Pool Rules are available for view on our website: http://www.WGRA.org.  I, and other members included in this membership (if applicable) do hereby agree to adhere to the WGRA Bylaws and other community rules of the facilities provided by the Association.  I agree to indemnify and hold harmless WGRA, its officers, members, agents and employees from any claim or loss for death, bodily injury, or property damage arising in any manner out of my presence or activities in the course of my participation at WGRA. (Typing your name constitutes signing your name to this agreement.) *
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