2019 Membership Dues (Active and Inactive)

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This is for current members of Nassau Swim Club (not new members, if you are new, please see the application under the become a member tab) Please make your payment after completing this form by mailing a check to us at Nassau Swim Club, PO Box 6, Yorktown, IN 47396 or clicking on the PayPal link just below this form

Email *

Head of Household Name *

Spouse Name (if applicable)

Names and birthdates of children who live with you

Primary Phone *

Secondary Phone

Mailing Address *

Membership Type *

Active Family Membership (due April 15) $375

Active Single/Senior membership (due April 15) $325

Inactive Member (due April 15) $25 per year until you wish to cancel or go active

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