Merrimack Pool | Equity Member Application

Complete this form and submit the non-refundable $50 application fee to apply for Merrimack Pool Equity Membership.

Questions? Contact: MerrimackPool@gmail.com.

Equity Member Waitlist Application

Payment Status
Account Types
Account Holder Name*
First Last
This will be the "Member of Record" and all pool records will be kept in this name. Family member names will be entered in the account upon clearing the wait list.
Birth Date*
MM
DD
YYYY
Address*
Street Address City State ZIP Code
Home Phone*
Cell Phone*
Email*

The email provided will be your account User Name and the primary method for receiving pool communications so please provide an address that is unlikely to change and that you check regularly.
Password*
Enter Password Confirm Password
Do you live within the pool boundaries?**
- Yes
- No
Priority is given to residents who live in or near the immediate neighborhood around the pool. This is the area bounded by Goldsboro Road (S), MacArthur Boulevard (W), Wilson Road (N), and River Road (E).
Terms and Conditions
Application is hereby made for membership in Merrimack Pool. If accepted, I agree to be responsible for full and timely payment of the equity fee (currently $1900, subject to change), annual dues, and any assessments established by the Board. I further agree that if offered a membership, I will either pay the then-official fee, or I will withdraw my application. I understand that offers of swim privileges and other pool communications are made by email or phone so I will be responsible for keeping my contact information up-to-date. If I cannot be reached it may impact my ability to receive swim privileges so I will contact MerrimackPool@gmail.com to make updates.
Affirmation*
- By checking this box I certify that the information is true and correct as of this date and I agree to the above terms and conditions.
Wait List Fee*
Price: $50.00
There is a one-time, non-refundable wait list fee.
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name