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www.HRCAonline.org l 303-791-2500
Renter Membership Information Form
 New Household
Property Owner or Management Co:
Tenant(s) on Lease:
Rental Property Address:
Home Phone of Renter:
Work Phone of Renter:
Emergency Phone of Renter:
Cell Phone of Renter:
Email of Renter:
 Update Household
Zip Code:
_____ ____ ____
Emergency Contact Name:
Family Information
M or F
Gender
ID Verified: 
ID Verified: 
ID Verified: 
ID Verified: 
ID Verified: 
ID Verified: 
ID Verified: 
I, the above listed tenant(s), hereby assume all of the above Association Member’s duties and obligations under the
Community Declaration and Supplemental Declaration applicable to the property being leased, with the exception of
any obligation(s) to pay assessments.
By signing below, I agree that the above information is correct and complete
Tenant Signature: ________________________________________ Date: _________________
Staff Use Only (PRINT ONLY)
Household ID #
Lot Code #
Staff Member:
Rec Trac #
Install Date:
Conversion/Merge Previous HH Address:
District Delegate #
Notes:
 Scanned Info HH documents
 Verified Names on Lease
AFS Signature __________________
____ ____ ____ ____
M or F
Gender
M or F
Gender
M or F
Gender
M or F
Gender
M or F
Gender
M or F
Gender
_____ ____ ____
DOB:
DOB:
DOB:
DOB:
DOB:
DOB:
DOB:
Tenant (on lease):
Tenant (on lease):
Household member:
Household member:
Household member:
Household member:
Household member:
www.HRCAonline.org l 303-791-2500
Consent to Tenant
To Be Filled Out By Homeowner:
Pursuant to Article III, Section 3.2 of the Supplemental Declaration for Annexed Property, and the
Community Declaration for Highlands Ranch Community Association Recreation Facilities, I grant the
use of my recreation privileges solely to the person(s) listed below who are leasing, renting my
property.
Address of rental property: __________________________________________________
Tenant (as shown on lease): __________________________________________
Tenant (as shown on lease): __________________________________________
Household Members (not listed on lease): _______________________________
_________________________________________________________________
_________________________________________________________________
Tenant Home or Cell Phone: ___________________
I understand that, in accordance with Article VI, Section 6.5 of the Community Declaration for the
Highlands Ranch Community Association, this delegation does not relieve me of liability for damage
to Association properties caused by my lessee/tenant. I also understand that in accordance with
Article III, Section 3.2 of the Supplemental Declaration applicable to my property, I remain responsible
for assessments made against my property by the Community Association. This delegation is
effective on the date stated below and shall remain in effect until I notify the Community Association,
in writing, that the delegation has been canceled.
Please Note: By signing this form you are aware that it is the
homeowner’s obligation to contact the Assessment Department
directly at 303-471-8958 to update the billing address for this property.
This form does NOT constitute a change of address for the
Assessment or Community Improvement Departments.
Date: _______________
Homeowner’s Name: _________________________ Signature: ___________________________
(Please Print)