Join – Poland Swim Club

To join our wait list please complete the form below.

Name of Applicant*
Enter the name of the person who should be contacted regarding any questions with your application.
First Last
Email*
Phone*
Birthday*
MM slash DD slash YYYY
Address*
Street Address City State ZIP Code
Username*
This is what you will use to log into your account.
Password*
Enter Password Confirm Password

Strength indicator

Select a password that you will use to access your account. You will be able to send a password reset link to the email address you entered above if necessary.
Spouse's Name
First Last
Spouse's Phone
Spouse's Email
Spouse's Birthday
MM slash DD slash YYYY
Type of Membership*
- Family
- Couple
- Senior
- Single
Child 1 Name
First Last
Child 1 Birthday
MM slash DD slash YYYY
Child 2 Name
First Last
Child 2 Birthday
MM slash DD slash YYYY
Child 3 Name
First Last
Child 3 Birthday
MM slash DD slash YYYY
Child 4 Name
First Last
Child 4 Birthday
MM slash DD slash YYYY
Child 5 Name
First Last
Child 5 Birthday
MM slash DD slash YYYY
Child 6 Name
First Last
Child 6 Birthday
MM slash DD slash YYYY
Dues Statement Type*
- Digital
- Paper (mailed to you)
By choosing "I agree," I hereby submit for membership in the Poland Swim Club, Inc. and agrees that if accepted, I will abide by the all of the rules, regulations, and bylaws of the corporation and also the terms of this contract as set forth below. Upon approval of the Membership committee and the Board of Trustees of the Poland Swim Club, Inc. you will be notified of your acceptance by the Membership Chairman. By choosing "I agree", you agree to purchase membership and present, in full, the initiation fee, current dues, and stock fee. The current cost of those items are the following: $275 initiation fee, $800 stock fee, and yearly dues for 2023 which are $550 for a family membership, $425 for couple, $325 for single, and $275 for senior. All fees are due upfront. The cost is subject to change based on board approval or membership specials at the time of purchase.*
- I agree
- I disagree
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