park plaza east pool 12404 e 38

2015 MEMBERSHIP INFORMATION
Early Bird by Apr 30th
after Apr 30th
Single/Sencillo – one person (una persona)
$100.00
Double/Doble – two immediate family members* (Dos familiars directos) $150.00
Family/Familia- three to five immediate family members*
$180.00
$140.00
$190.00
$220.00
(tres a cinco familiars directos)
For 6-8 immediate family* members add $10.00 each to the Family rate. 8 people max per membership.
*Immediate family members all living within the same household (parent(s), legal guardian, child)
(*Familiares directos: Son aquellos familiars que viven en la misma casa (padres, hijos, guardian legal)
Familiares directos addicionales $10 cada uno)
*REVIEW ALL MEMBERSHIP REQUIREMENTS ON REVERSE SIDE BEFORE MAILING APPLICATION
Please send a money order or credit card info to the PO Box below
A credit card payment slip can be printed off the Pool’s website
Early Bird applications with payment must be postmarked by Apr 3 0 th (no exceptions)
(Para ser elegible a nuestras tarifas de inscripcion temprana, su sobre debe tener matasellos del correo con fecha 30 de abril o antes.
S
( in exepciones)
YOU MAY JOIN IN AT THE POOL AND/OR PICKUP MEMBERSHIP CARDS on opening day - May23rd
CALL 918-622-7178 FOR MORE INFORMATION – Telephone in service after marchth 16
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - detach here and keep below portion for your information - - - - - - - - - - - - - - - - - - - - - - - - - - - -
MEMBERSHIP APPLICATION – 2015 / CALIDAD DE MIEMBRO - 2015
Park Plaza East Pool
P O Box 690842
Tulsa, OK 74169-0842
Mail to/Envie por Correo a:
Full Payment must be recieved
by April 30th to retain
the Early Bird rate
(All requested information must be completed in order to process your application.)
Single/Solo
Double/Doble
Family/Familia
Previous Member
New Member
(List all immediate family members that will be using the pool. Please print clearly.)
FULL NAME / NOMBRE COMPLETO
AGE / EDAD
BIRTHDATE/
FECHA DE
RELATIONSHIP /
NACIMIENTO RELACIÓN
1
/
/
2
/
/
3
4
/
/
/
/
5
ADDITIONAL MEMBERS - $10.00 EACH
6
7
/
/
/
/
/
/
Name (Nombre):
Bus. Phone: (tel. trabajo)
(Adult Member, Parent or Guardian)
Spouse (Esposo/a) :
Bus. Phone(Tel. de trabajo):
Cell Phone (cellul ar):
Home Address (Direccion):
City: (ciudad)
Email Address (Correo Electronico):
HEALTH CONCERNS / La SALUD
CONCIERNE
Home Phone (tel. de casa) :
Zip Code (Codigo Postal):_____________
Please provide so we can keep you updated on Parties and Special events.
Additional Emergency Name and Phone (REQUIRED) (contacto en caso de emergencia) :
CONSENT FOR MEDICAL TREATMENT
I affirm that the persons named on this application are my legal dependents. I hereby give my consent for emergency medical care prescribed for myself or for any member of
my family, by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions ar e necessary to preserve the life, limb or well
being of myself or any member of my family. I will not hold Park Plaza East Recreation Association, the Board of Directors or any of its employees responsible for an injury.
Date: _____ _ _ _ _ _ _
___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _
Signature of Adult Member, Parent or Legal Guardian/ Firma del miembro del adulto, padre, or guarda legal
PARK PLAZA EAST POOL 12404 E 38th St
Mailing Address - PO BOX 690842, Tulsa, OK 74169-0842
Receive a $20.00 concession card with a paid double or family membership referral (they must not have been a member in 2014 )
SPECIAL FEATURES
We are one of Tulsa’s Largest
outdoor pools!
* Concession Cards
* Free use of Gas Grills
* Fenced Baby Pool
* Lots of Lounge Chairs
* Sand Play Area
* Sand Volleyball Court
* High and Low Diving Boards
* Fully Stocked Snack Bar
* Private Party Rental
* Midnight Swim Parties
* Double Tube Slide
* Picnic Tables
MEMBERSHIP REQUIREMENTS
SINGLE
One person age 10 or above. Children
under 10 years old must be accompanied at all times by a
member 16 years of age or older.
DOUBLE Two immediate family* members.
FAMILY Three to five immediate family* members.
For 6-8 immediate family* members add $10.00 each
to the Family rate. 8 people max per membership.
*Immediate family members all living within the same household
(parent(s), legal guardian, child)
Call our office 918-622-7178 (*after March 16th)
or email us at [email protected]
Website: www.parkplazaeastpool.org
Anyone can join. Check website for hours of operation.

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