ELKS POOL & TENNIS CLUB 2022 MEMBERSHIP APPLICATION
Prices Effective: April 1, 2022

Please fill out COMPLETELY. Use this form if you are paying your pool dues online.
Items marked with * are required. They must be filled in before you can submit the form.

Applicant's Name*:

New member this year? yesno

Are you an Elks Lodge Member? yesno

Address:
Street*
City* Zip*

Phone:
Email:

Referred by?

Spouse:

Children/Ages:

Grandparents Names:

Membership Type*: —Please choose an option—Elk - Household membership $360Elk - Couple membership $235Elk - Single membership $150Non-Elk - Household membership $500Non-Elk - Couple membership $400Non-Elk - Single membership $250Youth membership (Ages 13-18) $150Elk - Add Grandparents $100Non-Elk - Add Grandparents $125

NOTES: Household membership available only for persons residing at the same address.
All credit card payments now incur an additional 3% processing fee.

Questions/Comments

Prove you're not a computer! Please answer this simple math question.*
3+5=