MIME-Version: 1.0 Content-Type: multipart/related; boundary="----=_NextPart_01C9C514.9E8EB460" This document is a Single File Web Page, also known as a Web Archive file. If you are seeing this message, your browser or editor doesn't support Web Archive files. Please download a browser that supports Web Archive, such as Microsoft Internet Explorer. ------=_NextPart_01C9C514.9E8EB460 Content-Location: file:///C:/0C84CAAD/2009Maintenancefeeform.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Swim Team Registration Form

BELAIR Swim & RACQUET CLUB

Mail To: &nb= sp;          Belair Swim & Racquet Club, Post Office Box 499,    =    Bowie, MD 20718

 

Family Last Name:  _______________________________________________________________=

The last name you provide on t= his line is the Last Name used for all Family Members. You may use a Hyphenated name if you would like as long as it is the name given at the gate when you enter.   Please List ALL = Family Members residing at this address in the form below – not just the Children.  If same as last yea= r just Check Box.

 

Address: _______________________________________________________Zip______________

Home Phone #: (_____)__________________  Work/Cell Phone #: (_____)_______= ____________ 
E-mail Address: {Please print clearly below 1 or more addresses. =  BSR sends out News Alerts via e-mai= l}

 

____________________= ____________________________________________________________

 

Enclose Check for 2009:

            Family Maintenance Fee of $450 (Due b= y 1 May):      &n= bsp;            = ;         &= nbsp;   $_______________

            Individual Maintenance Fee of $255 (Due b= y 1 May):      &n= bsp;               &= nbsp;   $_______________

            Late Fee of $25.00 (if Postmarked after 1 May):    &n= bsp;            = ;        $_______________

            Plus $25.00 for each additional month or part thereof as of 1 June: $_______________

            Swim Team and/or Tennis Registration Fees (include forms):     &n= bsp;    $_______________

            Monthly or Season Guest Pass Application Fees (forms on Web Site): $_____= __________

            =             &nb= sp;            =             &nb= sp;                  &= nbsp;  

            =             &nb= sp;            =             &nb= sp;            =           TOTAL AMOUNT ENCLOSED:   $_______________

Reminder – You MAY NOT automatically make yourself a “Single”.  If your family status has changed = please contact the Membership Chair to be added to the waiting list for Single memberships.  The By-Laws of t= he Club only allow for 25 of these types of Memberships.=

 

Membership Information Update

  CHECK HERE IF NO CHANGE FROM LAST = YEAR

Please use the back of this page to include additional children and a= ny relevant medical information (i.e. bee sting reactions, allergies, etc.) for each child.

** All persons in the Family Unit must,= per the Club By-Laws, “permanently and continuously reside in the member’s household.”

 

Name= s of Adults & Children Living at Home** (list additional = on back)   Bir= th Date:  (Month-Day-Year   )

 

1. _____________________________________________________(_______-_____-_______= _)

2. _____________________________________________________(_______-_____-_______= _)

3. _____________________________________________________(_______-_____-_______= _)

4. _____________________________________________________(_______-_____-_______= _)

5. _____________________________________________________(_______-_____-_______= _)

6. ______________________________________________= _______(_______-_____-________)

Please List AL= L Family Members on the lines above  &#= 8211; not just the Children.  Additi= onal names can go on back.

If we do not already have your digital photo, one will = be taken at Open House or at the Front Gate when you first visit the Club=

I would like to become more involved and help the following BSR Committees:

Swimming ____      Tennis _____        &= nbsp;   Social _____   Maintenance ______    Membership ______

 

Bounced Check Fee ̵= 1; Allow 4 weeks for Check to Clear.  An additional fee will be added for any bounced checks to recover penalty fee charged.      &n= bsp;            = ;            &n= bsp;            = ;                      &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             &nb= sp;      

For Pool Use Only

Date Received:______

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BSR Maintenance Fee Form Rev 2009

For Club & Membersh= ip information visit: www.bsrbarr= acudas.com

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