Membership Application

Please print, complete and mail with payment to the address below.  

CRESTLINE WALTON LAKE COMPANY

2018 NEW SOCIAL MEMBERSHIP

 

PLEASE PRINT:

    FIRST NAME: ______________&________________ LAST NAME____________________________________

 

   ADDRESS: ____________________________________ CITY/ZIP____________________________________

 

   EMAIL ADDRESS: _________________________________________ PHONE: (______) _______-___________

 

   PLEASE LIST THE NAME(S) AND AGES OF DEPENDENT CHILDREN LIVING AT HOME. 

   NOTE: ANY CHILD MARRIED OR 22 AND OLDER MUST HAVE THEIR OWN MEMBERSHIP.

             NAME                                                               AGE                                NAME                                                               AGE

 

               ___________________________       _______                             _____________________________      _______

                __________________________        _______                              _____________________________     _______ 

               ___________________________       _______                             _____________________________      _______

 

   NOTE: I AM BABYSITTING: Under 10 years of age $35.00 each

 

                 NAME____________________________________________ AGE______________________

 

                 NAME____________________________________________ AGE______________________

 

NEW MEMBERSHIP FEES:

 SINGLE OR MARRIED WITH CHILDREN               $225.00

                 SINGLE OR MARRIED WITHOUT CHILDREN     $200.00

                 SENIOR CITIZEN  (62 YEARS MIN.)                      $150.00

               

Two Character References:

 

                 Name:  ____________________________________ Phone # __________________________

 

                 Name:  ____________________________________ Phone # __________________________

 

Please mail your completed application with a check payable to:

Walton Lake Co.
P.O. Box 265
C
restline, Ohio 44827

 

By signing the application, I agree to abide by all the Rules and Regulations of the Crestline Walton Lake Company.  Membership in this organization is limited to members in good standing.  Anyone violating the rules will be asked to forfeit their membership and shall be barred from all privileges of Crestline Walton Lake Company.

 

  Signature ______________________________________________ Date ______________________

 

 

For Walton Lake Company use only:

 

              Date Paid:  ____________________________________

 

              Amount:    ____________________________________

 

              Check #:    ____________________________________

 

Membership #  ________________________________


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