To join our wait list please complete the form below. 1"Member of Record" Information2Membership Information3General Information4Application Fee & Payment "Member of Record" InformationBilling Contact Name(Required)This will be the "Member of Record" and all pool records will be kept in this name. We encourage you to login to your account to add family member names and be sure to include contact information for adults. First Last Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Birthdate(Required) MM slash DD slash YYYY Gender(Required)Please select oneFemaleMaleOther / prefer not to sayCell Phone(Required)Home PhoneWork PhoneEmail(Required)IMPORTANT! The email provided will be your account User Name and the primary method for receiving pool communications and the membership offer. Choose an address that is unlikely to change and that you check regularly. Also add us (Membership.Pool@AmityAC.org) to your safe sender list. This field is hidden when viewing the formUsernamePasswordSelect a password that you will use to access your account. You will be able to send a password reset link to the email address you entered above if necessary. Enter Password Confirm Password Strength indicator Membership InformationWE OFFER SEVERAL TYPES OF MEMBERSHIPS FAMILY MEMBERSHIP A FAMILY membership includes up to six members. Options are: --- Two Adults & up to Four Children OR One Adult & up to Five Children Available options (fees may apply) - Additional Children, Additional Adults, & Babysitters COUPLE MEMBERSHIP A COUPLE membership includes two members. Options are: --- Two Adults OR One Adult & One Child Available options (fees may apply) - Additional Children (2 & ↓) & Babysitters SINGLE MEMBERSHIP A membership includes One Adult. Available options (fees may apply) - Additional Children (2 & ↓) & Babysitters SENIOR COUPLE MEMBERSHIP A SENIOR COUPLE membership includes Two Adults (60 & ↑). SENIOR SINGLE MEMBERSHIP A SENIOR SINGLE membership includes One Adult (60 & ↑).Which membership is right for you?(Required)Family MembershipCouple MembershipSingle MembershipSenior Couple MembershipSenior Single MembershipAdditional Family MembersPlease add the family members you want listed on your account. To add, click the "Add Family Member" button below. This does not include babysitters. You will add them later. You may be asked to provide proof of residence or proof of full time student. Name Birthdate Relationship Actions Edit Delete There are no Entries. Add Family Member Maximum number of entries reached. General InformationHow did you hear about us?(Required)Please select oneAmity AC BasketballAmity AC SoccerAmity AC Swim TeamFlyer / HandoutMagazine / MailerOtherPeachjarPTC EventReferred by FriendRoad SignSocial Media - Facebook, Instagram, TwitterYou selected: Other(Required)How did you hear about us?Who referred you?(Required)Please let us know who referred you so we can thank them! Must provide their first & last name and their email address. It must be on their account to receive credit. First Last Are you interested in any of the following?Check all you are interested in. Swim Lessons (if available) Fitness Programs (if available) Amity AC Blue Marlin Swim Team Amity AC Basketball Amity AC Soccer Volunteering around the Pool (Maintenance/Repairs, Cleaning, Grounds Upkeep, etc.) Becoming a Sponsor Join an Amity AC Pool Committee (Events, Fund Raising, etc.) Select AllPlease feel free to leave a question or feedback. Application Fee & PaymentApplication Fee(Required)There is a one-time, non-refundable application fee that must be paid online at the time of application. Price: Payment Method(Required) Credit Card ACH (eCheck / Bank Transfer) Credit Card(Required) American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Security Code Cardholder Name ACH (eCheck / Bank Transfer)(Required) Account Number SelectSavingsChecking Account Type Routing Number Account Holder Name Subtotal $0.00 Credit Card Fee Price: $0.00 ACH (eCheck / Bank Transfer) Fee Price: $0.00 Grand Total CAPTCHAOrder Token
