North Orange Aquatic Center 2019 Pool Pass

First Name: Last Name:

Street Address: City: ZIP:

Email Address:

Cell Phone: Home Phone:

Emergency Contact: Emergency Contact Phone:

Proof of Residency

You will need to Upload copy of a utility bill - *Required in step 3

NO CHANGES AFTER APPLICATION IS PROCESSED. ALL SEASON PASSES ARE NON-REFUNDABLE AND NON-TRANSFERABLE

How many children 2 & under (free) will be on your pass?*CHILDREN 2 AND UNDER: (Birth dates must be after September 2nd 2016), ARE FREE, but must be listed on the application. Do not count when choosing the pass category and fee.

No children two and under
1 child two and under
2 children two and under
3 children two and under

Select Category*

EARLY BIRD PRICING New this year, purchase your pool pass on or before April 30, 2019 and get $10.00 off your price!!
If you mail your application and payment, envelope must be postmarked by April 30, 2019

Youth $80.00 (3 year olds - 12 year olds)
Adult $85.00
*Senior $60.00 (60 years +)
Family (2) $145.00
Family (3) $160.00
Family (4) $175.00

Babysitter $30.00 FEE*

One babysitter can be added to Season Pass Application as an additional person to the pass. However, all babysitters must be accompanied by the children without the parents at the pool. Babysitters may not utilize the pass individually. Babysitter must be at least 16 years of age.