2012 RAVN Pool Membership Application
Facility located at: 1626 Sonya Dr, Marietta, GA 30066
Date______ Amt Pd _____ Check # _____
Amount Due (Select one form of membership)
„ Family Membership $325.00 by 3-1-2012
„ Family Membership $350.00 by 5-1-2012
„ Family Membership $375.00 after 5-1-2012
„ Family Membership 2 Installments of $200.00 each ($400.00 total)
„ Social Membership $125.00
Name (Primary Member): ______________________________________
Address: _______________________________
Primary Ph #: ____________
Emergency Ph#: ____________
Email: __________________________________
Household Members Ages
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Please submit your completed application and payment to:
RAVN
P.O. Box 669221
Marietta, GA 30066
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