Membership - Bay Terrace Country Club, Pool Clubs in Bayside Queens, Swim Lessons in Bayside Queens

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New Seasonal RenterReturning Seasonal Renter

If so how many years rented?

Name of Seasonal Renter #1:

D.O.B

Name of Seasonal Renter #2:

D.O.B

Street Address:

City:

State

Zip Code:

How long at this address?

Telephone# (Home):

Cell Phone#:

E-Mail:

Secondary E-Mail:

Emergency Contact / Relationship / Phone#:

Name of Children / Date of Birth / Gender

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FEES ARE NON-REFUNDABLE- THERE IS A $50.00 RETURN CHECK FEE