Rollingwood Pool Application for Membership

The undersigned hereby submits application for membership in Rollingwood Pool, Inc.,
and agrees that if approved and accepted, the applicant and all members of the family unit, as
defined by the by-laws, will abide by all the rules, regulations, and by-laws of the corporation.

Billing Contact Name*
Enter the name of the person who should be contacted regarding any questions about the account.
First Last
Employer/Occupation*
Spouse's Name*
First Last
Employer/Occupation
Address*
Street Address City State ZIP Code
Phone*
Email*
Referred By

If you were referred by a member, please provide their name.
Username*

This is what you will use to log into your waitlist account.
Password*
Enter Password Confirm Password

Strength indicator

Select 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.
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Waitlist Fee
Price:
Processing Fee
Price:
Total
$0.00
CAPTCHA
Comments
This field is for validation purposes and should be left unchanged.

Waitlist Application

Rollingwood Pool Application for Membership