Full Season Premium Membership: RSC GOLD

The Place To Be In 2015
215-357-9567
750 Second Street Pike • Richboro PA 18954
RichboroSwimClub.com
Full Season Premium
Membership: RSC GOLD
LAST NAME
FIRST E-MAIL
ADDRESS
ZIP
TOWN
2015
YEAR
PHONE
PLEASE READ CAREFULLY AND SIGN BELOW
Application for Annual Membership is hereby made to Richboro Swim Club. I/we agree that if elected to membership by the committee, to
abide by all the rules and regulations of the club. I agree to release the club and property owners from all liability from my, or my guests'
participation in any sport, exercise or activity of the club.
SIGNATURE____________________________________________
Full Name
(including signer above)
Birth Date
MO/DAY/YR
SEX (M/F)
I am paying in FULL - Amount Due (Circle one from chart below)
R IC H BORO S WIM C LUB 2015 M EM BERSH IP SCH EDU LE
Single.................................................................$559
Family of 2........................................................$817
Family of 3*......................................................$917
Family of 4*......................................................$1017
Each member over four people*.......................$97
Senior Citizens (single over 60)........................$397
Couple both over 60..........................................$497
Teenagers (14 thru 18)†....................................$257
Children under 2 on June 1, 2015....................No Charge
*Family memberships may include members of immediate family or live in caregivers residing at the same address.
+Includes Club Swim Team fee, if applicable. Swim and Diving Team Fees—$44 per child per sport (swimming and or diving).
Guest fees—Weekday and Weekend/Holiday guest fees for adults and children are based on membership type (see above).
After 5:00 pm, adults and children $7 for all membership types. Members under 18 limited to 1 guest daily. Special 10 pass guest
card available and priced based on membership type. Guest card good anytime during 2015 season.
Discount rates apply for memberships PAID IN FULL by discount dates. No refunds (except for new member early season trial offer). Your cancelled
check, credit card or cash payment receipt is proof of acceptance of membership. The club uses a computerized ID system. Your photos will be taken
on one of your first visits to the Club. Children under 14 years old may join only with another family member who is 21 years or older. Children 14
and over are required to bring proof of age to join as an individual.
Check enclosed for payment in full in the amount $ ________ or please charge to my ____ VISA ____ MasterCard # ______________________
Expiration Date ___________ CID # _________ (last 3 digits on signature panel)