ALL MEMBERS (inactive included): Please fill in this form and return with 2011 fees by May 1, 2011 to:

WPRA

PO Box 1377

Yorktown, VA 23692-1377

ATTN: Membership

Primary Adult(s) Name(s): ___________________________________________ Member #:____________

Address: _______________________________________________________ Zip Code: ________________

Home Phone: _____________________________________________________________________________

Cell Phone (for emergency use only): __________________________________________________________

E-Mail (please provide to help us cut down on the cost of printing and mailing newsletters, notices, and fliers.) __________________________________________________________________________________________

Other Adult(s) other than spouse:

---Defined as all those over 18 who share the same permanent, year round address with primary adult(s). This includes children in college who are home for the summer. Does not include summer visitors; special passes are available in these cases.

______________________________________

______________________________________

______________________________________

Children (18 and under):

---Defined as the children/step-children of the primary member/spouse and/or any children who share the same permanent, year round address with primary adult(s). This category also includes exchange students and locally residing grandchildren of members who pay the full membership rate. Summer visitors are not included; special passes are available in these cases.

Name Age

__________________________________________________________

__________________________________________________________

__________________________________________________________

__________________________________________________________

Full Time Babysitter(s) (must be employed on a full time basis):

______________________________________

______________________________________

VOLUNTEERS NEEDED: We are looking for members who are willing to volunteer their time and skills

to help keep our pool in functional order. Please consider helping out. Upkeep of a pool is very expensive and our pool is no spring chicken. The more volunteers we have the less we have to pay someone to do these tasks for us.

General Maintenance/Help:

___ Mowing ___ Painting ____ General “Fix-it” ___ Clean-up Days ___ Soliciting Sponsors

Professional/Skilled Help:

___ Plumbing ___ Electrical ___ Carpentry ___ Concrete Work ___ Other (List) ____________________

WPRA Board of Directors: ____ I would be interested in being a part of the Board

WPRA Membership Directory Information:

The purpose of the directory is to allow members to get in touch with each other; information is not shared and directories are only given to members. You choose what info is included. Please select from the following:

____ Please do not include my info in the directory

____ Please DO include the following information (info is listed under primary adult/spouse name):

____ Home address ____ Home Phone ____Cell Phone ____ Email ____ Names of children and/or other adults who are included on your membership (List) ___________________________________________

Please check payment enclosed (Due May 1, 2011; late fee applied after a May 15, 2011 postmark):

A. Returning Members:

____ 2011 Membership Dues in full ($325)

____ 2011 Membership Dues Installment # ____ in the amount of ________

____ 2011 Membership Dues and Stock Payment in full ($725)

____ 2011 Membership Dues and Stock Payment Installment # ____ in the amount of ________

____ Senior Membership Dues ($162) (Members who turn 60 by May 15, 2011. Please refer to newsletter or WPRA Rules & Regs for full details. This membership rate only includes primary member and spouse, no other family members).

____ Inactive Fee ($50) (Please refer to newsletter or WPRA Rules & Regs for full details)

____ Late Fee ($25) (postmarked after May 15, 2011)

B. New Members:

____ 2011 Membership Dues ($325) and Registration Fee ($75) (total $400; pro-rated rates available if joining after season begins; no late fee)

*** Did a current pool member refer you? Please tell us who ________________________________

* If paying in installments, please send form with first payment. For subsequent payments, please include member and payment numbers on subject line of check. Remember 2011 dues may be divided into 3 payments. If paying stock and dues, up to 4 payments may be made. Please Note: The final payment due by the May 1, 2011 deadline with a late fee applied if postmarked after May 15^th.

STOCK MEMBERS ONLY: WPRA Membership Handbook Agreement:

____ I have received the WPRA Membership Handbook and have read and agree to abide by the Rules & Regulations and By-Laws of the organization. I understand any amendments to these will be provided to me through the newsletter and website. Should I have a question or concern I understand that it is my right to bring it before the WPRA Board.

____ I have not received the WPRA Handbook. Please send one.

Stock Member Signature _____________________________________________

NEW IN 2011: Vouchers for your member ID cards will be mailed with your receipt to enable easier pick up.

QUESTIONS? Please contact Lisa Angwin, Membership Chairman at 874-0473 or lbgangwin@cox.net