We look forward to seeing you this Summer!

Register today to create your Member account and we’ll get you setup and approved for all the fun.

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Please fill out this form to create an account with Hasbrouck Heights Swim Club. All applications will be reviewed for approval prior to acceptance.

Account Information

Your Name*
Address*
This will be the username for your online account.

Family Members

Please enter the total number of people who will be using this membership including yourself. E.g.,: For yourself plus a spouse and one child enter 3. DO NOT INCLUDE OR LIST NANNY PASS (will be done when invoicing)
Spouse/Partner Name
Child 1
MM slash DD slash YYYY
Child 2
MM slash DD slash YYYY
Child 3
MM slash DD slash YYYY
Child 4
MM slash DD slash YYYY
Child 5
MM slash DD slash YYYY
Child 6
MM slash DD slash YYYY
ALL MEMBERS MUST BE FULL-TIME RESIDENTS AT YOUR LISTED ADDRESS. Please enter the member who you would like to request be added to the account, with name, DOB (mm/dd/yyyy), and relationship ie.:Johnny Tentpeg 04/15/2011

HASBROUCK HEIGHTS SPONSORS

PLEASE LIST 3 CURRENT HASBROUCK HEIGHTS MEMBERS AS SPONSORS
Referral #1*
Referral #2*
Referral #3*
Referral #4
Referral #5
PLEASE UPLOAD PROOF OF RESIDENCY FOR ANYONE WHO IS ON YOUR MEMBERSHIP THAT 18 OR OLDER
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