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Pool Registration Form
admin
2021-05-17T10:50:57-04:00
2022 Potomac Crossing Owners Pool Application
Please fill in the information below:
Potomac Crossing Property Address:
*
Phone
*
Emergency Phone
Email Address:
*
Member Application (Required)
Please complete the fields below by clicking "Add Entry" for each member that resides in the household. If you have a pass from last year, please indicate that on this application and we will provide a new sticker to be put on the back of your pool pass. If this is your first time submitting a pool application please complete and include photographs as described below. No pass is needed for children age 2 and younger.
Please ADD ENTRY for each member of your household. Use Self as "Relationship to Owner"
First Name
Last Name
Relationship to Owner
Date of Birth (if under 18)
Allergic Reactions to Medications
New Pass or Renewal Sticker
Actions
Edit
Delete
There are no
Entries.
Add Entry
Maximum number of entries reached.
Please upload a profile picture in order of the above list for each new applicant above include a photograph, uploaded in jpg, gif or png format. If no photograph is included, we will not be able to issue a pass for that family member. If you have a pass from last year, please indicate that on the above portion of the application and we will provide a new sticker to be put on the back of your pool pass. A new pool pass picture is required every 2 years for members that are 2 to 18 years of age. No pass is needed for children age 2 and younger.
Applicant Profile Image 1
Max. file size: 50 MB.
Applicant Profile Image 2
Max. file size: 50 MB.
Applicant Profile Image 3
Max. file size: 50 MB.
Applicant Profile Image 4
Max. file size: 50 MB.
Applicant Profile Image 5
Max. file size: 50 MB.
Applicant Profile Image 6
Max. file size: 50 MB.
Submit Pool Application Request Form
Your submission will be received via email. For all other correspondence: Property Management People 552 Fort Evans Road, Suite 202 Leesburg, VA 20176 Fax: 703-771-9366 (Renewals Only) E-mail: pooladmin@pmpbiz.com PASSES ARE NOT MAILED, BUT WILL BE AVAILABLE FOR PICK-UP AT THE POOL.
Consent
*
I have reviewed and agreed to the
Pool Rules & Regulations (click here to view)
Signature
Homeowner or Tenant Signature
Today's Date
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