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2. Thank you for your interest in a Splash Program membership!
   Please complete this form with all of the required information. When you complete the form, please submit and a team member will be in touch with you shortly.
4. Section 1: Parent Information
6. Parent First Name*
7. Parent Last Name*
9. Email Address*
10. Phone Number*
14. Section 2: Membership Status
16. Is the participant a CRC member? *

    1. Yes, the participant is a current CRC Member
    2. No, the participant is not a current CRC Member
18. If the participant is not a current member, please complete section 4 of this form. If the participant is a current member, please skip section 4 of this form.
    Splash memberships require a current CRC membership for at minimum the participant. The Splash membership will draft the same day as the CRC membership. If you already have a CRC membership we will set up the draft to match. Unless otherwise specified, we will use the checking account currently drafting for the CRC membership.
22. Section 3: Participant Information
24. Participant First Name*
25. Participant Last Name*
27. Participant Date of Birth*
28. What date do you want to start your membership?*
30. Primary Phone Number*
34. Section 4: New Membership
36. Address
38. City
39. State
40. Zip Code
42. Secondary Phone Number
44. Email Address
46. What date do you prefer to draft on (1st or 15th)?

    1. I would prefer to draft on the 1st of the month
    2. I would prefer to draft on the 15th of the month
48. What type of membership?

    Please select your membership type.

    1. Adult (one adult + all children living in residence under 22)
    2. Family (two adults + all children living in residence under 22)
    3. Youth/Teen (one youth/young adult, age 12-21) (under 12 ok for Splash memberships)
    4. Special Hours (one adult access only M-F 10am-4pm + weekends)
    5. Couple Special Hours (two adults access only M-F 10am-4pm + weekends)
50. Do you have any comments or questions?
Leave This Blank:


52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit

* indicates a required field