TODAY'S DATE_________________________________

DATE & TIME OF POOL PARTY________________________________________________

NAME, ADDRESS, AND PHONE NUMBER OF MEMBER REQUESTING POOL PARTY: _____________________________________________________________________________ _____________________________________________________________________________

Parties must be approved two weeks in advance by board representative on a first come, first served basis. Two lifeguards are required and must be paid $12.50 per hour each in cash at the time of the pool party. A security deposit of $50.00 must be paid at the time the request is submitted. Homeowners are responsible for all damages and must be in attendance at the pool party. If any of the attendees are under 18 years of age, there needs to be an adult for every 5 persons present. All pool parties are subject to rules and regulations of Willow Farm Pool & Homes Association.

DATE REQUEST RECEIVED__________________________________________________

RECEIVED BY______________________________________________________________

ACTION TAKEN: APPROVED / REJECTED

(Circle One) COMMENTS:_______________________________________________________________ ___________________________________________________________________________

DATE NOTIFICATION MADE_________________________________________________

PERSON NOTIFIED__________________________________________________________

NOTIFIED BY_______________________________________________________________

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