Contact Information

Membership Information


All Members (including the person above) using the pool over the age of 2 years from this household:
(Documentation may be requested to prove residency).

Member 1
Member 2
Member 3
Member 4

Additional Family Members in Residence

Select the number and fill in information for additional family members under the age of 2 years or additional family members to be added onto your Family of 4 Membership
The fee will automatically be removed if the member is 2 years old or younger.

Number of Additional Family Members

+ $

Member 5
Member 6
Member 7
Member 8
Member 9
Member 10

Release of All Claims and Promise Not to Sue

As participants in this and any other programs of Swiminc Inc, we recognize and acknowledge that there are certain risks and agree to assume all such risks including any damages resulting from physical injuries, death, loss of services or consortium, loss or damage to property, or any other loss which may be sustained as a result of participating in any and all activities connected with Swiminc Inc and its programs.

In consideration of Swiminc Inc accepting this contract, and with the intent to be legally bound, I hereby, for all participants of this contract, all heirs, executors, administrators and assigns, do hereby forever release, waive and relinquish all claims resulting from participation in this and all other programs of Swiminc Inc. Furthermore, I promise not to sue Swiminc Inc and agree to indemnify and hold harmless and defend Swiminc Inc and its officers, agents, servants, employees and insurers, from any and all liabilities, claims, demands, actions or causes of action resulting from physical injuries, including death, loss of services or consortium, loss or damage to property, or any other loss which these participants may have, or which may accrue on account of participation in this and all other programs of Swiminc Inc.

For your health and safety, Worthington Pools have important Facility Rules and Regulations. These can be found on our website www.WorthingtonPools.com with written copies available at the pool.

Release of All Claims and Promise Not to Sue

As a participant in this and any other programs of Swiminc Inc, I recognize and acknowledge that there are certain risks and I agree to assume all such risks including any damages resulting from physical injuries, death, loss of services or consortium, loss or damage to property, or any other loss which I may sustain as a result of participating in any and all activities connected with Swiminc Inc and its programs.

In consideration of Swiminc Inc accepting me or my child's registration, and with the intent to be legally bound, I hereby, for myself, for my child, all heirs, executors, administrators and assigns, do hereby forever release, waive and relinquish all claims I have or may have as a result of participating in this and all other programs of Swiminc Inc. Furthermore, I promise not to sue Swiminc Inc and agree to indemnify and hold harmless and defend Swiminc Inc and its officers, agents, servants, employees and insurers, from any and all liabilities, claims, demands, actions or causes of action resulting from physical injuries, including death, loss of services or consortium,, loss or damage to property, or any other loss which I may have or my child may have, or which may accrue to me on account of my participation in this and all other programs of Swiminc Inc.

I authorize Swiminc Inc to use photos, and or other likeness' of myself and or my child or the child for whom I have legal guardianship for any promotional materials regarding Swiminc Inc programs, facilities, or services. Such likeness' will not be sold to other parties. Promotional materials bearing these likenesses may be distributed for free to the public and posted on websites operated by Swiminc Inc. The names of individuals in the photos will not be used in the publication of the promotional materials.