Online Registration with payment by CHECK – Pool Membership

Pool Membership Application - check payments only

Fields marked with an * are required

This field is for adding an optional contribution to LPRA, which we have suggested for those paying online to help cover the 3% payment processing fees.

New members are subject to a one-time initiation fee of $150.

Member #1

Member #2

Member #3

Please list any child members below (if applicable):

PLEASE NOTE THAT ALL PAYMENTS ARE NON-REFUNDABLE.

Enter your initials below to indicate that you have read and agreed with the terms of the Assumption of Risk and Medical Permission and Release.

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