Electronic Card Access Request Form

Please complete all fields on this form through the e-Mail address field to receive your amenity pass. All other fields will be completed at the management office at time of pick up. Please allow 24-48 hours for processing. One pass per family wil be given. Additional passes will be charged per the Board's requirements. After completing the form, please update any information in the address book. YOUR ACCOUNT MUST BE IN GOOD STANDING WITH THE ASSOCIATION. CHILDREN UNDER AGE 14 MUST BE ACCOMPANIED BY A PARENT OR AN ADULT, 21 YEARS OR OLDER. ONCE ADMITTED TO THE AMENITY AREAS, BEARER OF CARD ACCESS AGREES TO ABIDE BY ALL POOL RULES, TENNIS COURT RULES AND BASKETBALL RULES AND UNDERSTANDS THAT VIOLATION OF RULES WILL RESULT IN EJECTION FROM THE AMENITY AREAS AND/OR COMPLETE LOSS OF FURTHER ENTRY PRIVILEGES.
Homeowner Name:
Address:
Rent/Lease:
Daytime Phone Number:
Home Phone Number:
Cellular Phone Number:
eMail Address:
Office Use Only
Homeowner Signature:
Account Balance:
Office Intials:
Activation Date:
De-Activation Date:
Pick-up Date:
Reason:

Office Use Only