EVERGREEN VALLEY RECREATIONAL CLUB
MEMBERSHIP APPLICATION

Membership definition:  Membership is limited to: Two adults, their dependent children, and any member parents who reside at the member address.  Members may bring up to 3 guests per day. 

Please Print
Name of applicant:  	E-mail address:  	
Address:  	City:  	Zip:  	

Household members other than applicant (must be filled in completely).   

(2)  		(3)  	
Relationship  		Relationship  	
Birthday          /         /    		Birthday          /         /    	
(4)  		(5)  	
Relationship  		Relationship  	
Birthday          /         /    		Birthday          /         /    	
(6)  		(7)  	
Relationship  		Relationship  	
Birthday          /         /    		Birthday          /         /    	

MEMBERSHIP FEE	No Cash – Checks or money orders ONLY    $ 375.00

There is a refundable $20.00 key deposit.  At the end of the swim season, return your 2 keys and your $20.00 deposit will be refunded.

TOTAL							                        $ $395.00

EMERGENCYINFORMATION: In case of an emergency please call:
Member's home phone:  	Member's work phone:  	
Friend or Relative: Name:  	Phone:  	

I HEREBY AGREE TO ABIDE BY THE POOL RULES AND REGULATIONS. I UNDERSTAND THAT SHOULD MY FAMILY, MY GUESTS, OR I WILLFULLY DISOBEY THE RULES AND REGULATIONS, MY MEMBERSHIP CAN AND WILL BE TERMINATED WITHOUT REFUND.
 
Upon signing this agreement I agree to pay Evergreen Valley Recreational Club in return for Membership in said club the sum total of $375.00 plus a refundable $20.00 key deposit.

EVERGREEN VALLEY RECREATIONAL CLUB
3380 WOODSIDE LANE
SAN JOSÉ, CA  95121
(408) 327-9201

SIGNATURE___________________________________________________ DATE_______________ (rev. 06/07)

(OVER -- You must sign both sides of this contract/application to receive your pool keys)

EVERGREENVALLEY RECREATIONAL CLUB
(EVRC)

MEMBERSHIP CONTRACT

My family and guests agree to indemnify the EVRC Club, its officers, members and agents and hold them harmless from and against all loss, damage, expense and liability resulting from injury to or death of any person and loss of or damage to property or claims of such injury, the above addressed facilities. In addition, applicant waives all claims or causes of action against EVRC, its officers, members, and agents for damage to or loss of property of any kind or for injury to persons occurring in or upon the facility arising from any cause other than the negligence or willful misconduct of the Club, members, and agents and to which the applicant and/or his agent in no way contributed, either actively or passively, causing such damage, loss or injury.

In addition, members and their guests agree to abide by the rules, regulations and conditions adopted by EVRC as set forth in the By-laws of said Club and understand that permission for the use of facilities is contingent upon compliance with these rules, regulations, and conditions.

The member agrees to these conditions and understands them. They also understand that any guests must be made aware of said agreement, rules and regulations and conditions. They understand that guests are the members’ responsibility and that membership may be terminated or monetary damage due for property damage that their guests are responsible for while in the facilities with said member.

I understand the statements above and agree to them.

Authorized Signature:  ___________________________________
Please print name:  _____________________________________
Date:  ________________________________________________(rev. 06/07)