Community Center : Membership Agreement - 3 Month Contract

Membership Agreement - 3 Month Contract

Please fill out the following form to register for a 3-month membership at the Brushy Creek Community Center. Once you click the submit button below, your request will be sent to Customer Service who will contact you within one business day to collect payment information.

MEMBER INFORMATION:
Last Name:	First Name:	M.I.:
Street Address:	City:	Zip:
Home Phone:	Cell Phone:	DOB:
Email Address:	Allergies:	Sex:	M F

Would you like to receive information from the Community Center via email? Yes No
EMPLOYER INFORMATION:
Employer:	Work Phone:

EMERGENCY INFORMATION:
Name:	Phone:	Relation:
Name:	Phone:	Relation:

MEMBERSHIP AND PRICING OPTIONS:
Short Term:	3-Month Term **
Resident Individual *	$60
Non-Resident Individual *	$120
* All New and Renewed (over thirty (30) days of expiration) Memberships require a $25 Activation Fee.
** Short-term memberships must be paid in full at time of purchase.

CONTRACT TERMS: 1) I understand that I am signing a binding contract with Brushy Creek Municipal Utility District. 2) I understand that the membership length is for 3 months from activation date. 3) I understand that I cannot upgrade my membership package until the 3 months have passed from activation date. 4) I understand that I will not receive "credit" or "pro-rated fee" at the end of the 3 months if I wish to sign an annual contract. 5) This membership does not apply to receiving discounts on Rentals and Camp Foxtail. 6) I agree that I have been informed that the Membership Policies are posted on the District's website (See link below), and I have had an opportunity to review such policies. I agree that such policies are a part of this contract. 7) I agree the Board of Directors of Brushy Creek MUD may change membership policies, privileges, fees, and dues at any time. Any change in membership fees will become effective with 60 days notice given on the District's website. An email notification will also be sent to current members who have an email address on file with us. 8) I assume full responsibilities for any property damage or personal injury caused by me or my family members. 9) I agree to assume sole responsibility, and to release and hold harmless Brushy Creek MUD, for any personal injury or losses sustained by me or my family members while on the Community Center Premises. 10) I agree to indemnify Brushy Creek MUD, its Directors, Employees, Contractors, Agents and Representatives for any costs, claims, damages, demands, losses and causes of action, including reasonable attorneys' fees, arising out of or related to any personal injury sustained by me or my family members while participating in recreational activities or utilizing the Brushy Creek Community Center Facilities. Membership Policies & Rules I agree to the Contract Terms and Membership Policies: Signature: Date:

Customer Service will call you to obtain payment information.