New Member Application

2010 Keystone Klub, Inc.
PO Box 34042 • Omaha, NE 68134
www.keystonepool.com
APPLICATION FOR MEMBERSHIP

If accepted as a member of the Keystone Klub, I agree to abide by all rules, regulations, and by-laws that are now in existence, or which may hereafter be adopted by the Board of Directors. It is understood that all members of any immediate family, within my household* may enjoy the privileges of the club and its facilities, as they are made available. I further understand that my membership, which will be evidenced by a non-interest bearing bond of Keystone Klub, Inc., is a voting membership and that the $100.00 bond is non-refundable. It is transferable providing I have paid my dues during the last year and do not owe the pool any money. There is a $25.00 transfer fee.

2010 Dues are due May 8, 2010.

Every swim year after the first swim year fees may include both an annual dues fee plus a pool maintenance fee. When annual fees are not paid the membership becomes inactive. After one year of inactive status the membership expires and a new application for membership willbe required.
*‘Family members within a household’ is restricted to only those that you claim as dependents on your taxes.

2010 Keystone Klub, Inc. PO Box 34042 • Omaha, NE 68134 www.keystonepool.com APPLICATION FOR MEMBERSHIP If accepted as a member of the Keystone Klub, I agree to abide by all rules, regulations, and by-laws that are now in existence, or which may hereafter be adopted by the Board of Directors. It is understood that all members of any immediate family, within my household* may enjoy the privileges of the club and its facilities, as they are made available. I further understand that my membership, which will be evidenced by a non-interest bearing bond of Keystone Klub, Inc., is a voting membership and that the $100.00 bond is non-refundable. It is transferable providing I have paid my dues during the last year and do not owe the pool any money. There is a $25.00 transfer fee. 2010 Dues are due May 8, 2010. Every swim year after the first swim year fees may include both an annual dues fee plus a pool maintenance fee. When annual fees are not paid the membership becomes inactive. After one year of inactive status the membership expires and a new application for membership willbe required. *‘Family members within a household’ is restricted to only those that you claim as dependents on your taxes.
Name (Father)
Employer
Work Phone
Additional Phone
Name (Mother)
Employer
Work Phone
Additional Phone
Home Address
Home Phone
E-mail Address
Date of Birth		Children's Names







I hereby apply for a Family Membership in Keystone Klub, Inc.
Date:	Signature (Please print):
Please check all that apply:
	2010 Family Membership $325
	2010 Single/Empty Nest Membership $200
	New Bond $100
	Bond Transfer Fee $25
	Ten Visit Guest Pass $35

After Submitting Form you can send a check with the appropriate amount to Keystone Klub Pool P.O. BOX 34042 OMAHA NE 68134 PAYPAL PAYMENTS WILL BE ACCEPTED SOON!