First and last Name:
Spouse Name:
Home Address:
E-mail address:
Can we publish your email in the directory?
Yes
No
Directory Request
Residency:
New Resident (less than 1 year)
Seasoned Resident (over 1 year)
Best time to reach you:
Day (8am-5pm)
Evening (5pm-9pm)
Pool Acknowledgment
This home is in:
Please select your Subdivision
Bedford Downs
Foxfield
Foxfield Estates
Home phone (###-###-####):
Work phone (###-###-####):
Cell phone (###-###-####):
Spouse Cell phone (###-###-####):
List the names and ages of all children under the age of 18 Living at the above address:
Name:
Age:
Name:
Age:
Name:
Age:
Name:
Age:
Name:
Age:
Name:
Age:
It is understood and acknowledged by the homes association member resident(s) named on this form that:
There is no life guard or attendant on duty at the Bedford Downs Homes Association
swimming pool facilities. Therefore, I/we acknowledge that any member of my/our family and/or my/our guests use these facilities at our own risk.
All children under the age of fourteen (14) must be supervised by their parent or other adult guardian who is eighteen (18) years or older at all times while at the facilities.
We/I have received and read a copy of the Swimming Pool Facilities Rules and Regulations and all members of this family and guests will honor and abide by said Rules and Regulations and any published changes thereof. It is understood that violations of the Rules and Regulations may result in the suspension of our family swimming pool priviledges for a designated period of time.
Download/view the Rules and Regulations now.
Release
By submitting this form, I/we state I/we are members in good standing of the Bedford Downs Homes Association, for the consideration and use of the swimming pool facilities owned by Bedford Downs Homes Association hereby acknowledge and release said Bedford Downs Homes Association and their assigns, and all other persons, firms and corporations, both known and unknown of and from any and all claims, demands, causes of action or suits at law, which could arise as a result of the use of said homes association swimming pool facilities located at or about 12802 West 119th Terrace in Overland Park, Kansas by the above named homeowner(s), including members of that family and/or guests of that family. I/we understand it will be my/our responsibility to properly conduct myself/ourselves and comply with all the homes association's "Swimming Pool Facilities Rules and Regulations," of which I/we have received a copy and fully understand, in order to avoid personal injury or property damage.
By agreeing to this release, you are stating you have read the above release and the acknowledgement, have completed this form accurately and truthfully and you and family agree to abide the Rules and Regulations and this Release.
By disagreeing to this release, you are stating you do not agree to the release and/or the Rules and Regulations.
Select One
I Agree
I Disagree
Name of the person submitting this form.
(Note: Only this submitter or the above named adult homeowner is authorized to pick up the swipe card.)
Today's date (mm/dd/yyyy):