Membership Application

After submission, you must submit your membership fees.
Submit payment at the pool upon first visit, drop off to the black drop box by the pool entrance, or mail to:

Southbridge Pool, PO Box 176, Waunakee, WI 53597.
(Checks payable to Southbridge Neighborhood Pool.)

You may not access the pool until payment is received.

House Number

Street Name

Family Last Name

Applicant Name

First Name

Last Name

Applicant Date of Birth

YYYY

Applicant Email

Applicant Phone

(###)

###

####

Co-applicant Name

First Name

Last Name

Co-applicant Date of Birth

YYYY

Co-applicant Email

Co-applicant Phone

(###)

###

####

Membership

Pool membership is available to property owners in Southbridge Neighborhood and Blue Ridge Addition, Waunakee Wisconsin. Memberships do not transfer to new owners upon sale of a property. A membership will transfer with a property owner should they purchase a new property within the pool membership boundaries. Fee: $1,000 one-time membership fee

Annual Dues - Single/Couple

Single/couple annual dues are available to adult members listed as applicants above. Fee: $275 annual fee

Annual Dues - Family

Family access is available ONLY to individuals living in the household for the duration of the pool season. All information below must be completed for each additional family member. Fee: $375 annual fee

Household members in addition to the applicant and co-applicant listed above.

Additional Member #1

First Name

Last Name

Additional Member #1 Birthdate

YYYY

Additional Member #2

First Name

Last Name

Additional Member #2 Birthdate

YYYY

Additional Member #3

First Name

Last Name

Additional Member #3 Birthdate

YYYY

Additional Member #4

First Name

Last Name

Additional Member #4 Birthdate

YYYY

Additional Member #5

First Name

Last Name

Additional Member #5 Birthdate

YYYY

Additional Member #6

First Name

Last Name

Additional Member #6 Birthdate

YYYY

Additional Member #7

First Name

Last Name

Additional Member #7 Birthdate

YYYY

Additional Member #8

First Name

Last Name

Additional Member #8 Birthdate

YYYY

Babysitter Pass

Babysitter pass can be purchased when annual dues are paid. The Babysitter pass may only be used by a single person (age 14+) or grandparent couple while accompanying children (under age 13) from the member household.

Fee Summary

Select the applicable fees and submit payment at the pool upon first visit, drop off to the black drop box by the pool entrance, or mail to: Southbridge Pool, PO Box 176, Waunakee, WI 53597. (Checks payable to Southbridge Neighborhood Pool.) You may not access the pool until payment is received.

$1,000 Membership Fee

$275 Annual Dues - Single/Couple

$375 Annual Dues - Family

$20 Babysitter Pass

Acknowledgement of Rules, Liability Waiver, & Release of Claims

By submitting this application, we agree to abide by the articles of incorporation, by-laws, and the pool rules of Southbridge Neighborhood Pool, Inc. I/we also agree that on behalf of ourselves and our children, that use of the facilities at the Southbridge Neighborhood Pool is at our own risk. Among all other risks inherent in the use of the Southbridge Neighborhood Pool, we are specifically aware of the risks associated with contracting COVID-19 and are aware that we may be exposed to COVID-19 while at the Southbridge Neighborhood Pool. I/we fully release and agree not to sue Southbridge Neighborhood Pool, Inc., its Board of Directors, employees, and volunteers from and for any claim or cause of action related in any way to my/our use of or presence at the Southbridge Neighborhood Pool.

All household members aged 18+ years shall acknowledge the above by typing their name below.

Applicant name (Signature)

Co-Applicant name (Signature)

Additional adult household member name (Signature)