Application for Membership

TO: Splashwin’s Fun Park

FORM A
We wish to apply for the following:

Type of Membership:

☐ Monthly/ Single $500 per year

☐ Monthly/ Family $300 per year

☐ Single/ Annual $500 per year

☐ Couple/ Annual $800 per year

☐ Family/ Annual $1500 per year

☐ Lifetime/ Family $10,000.00

We enclose cheque for $................ on

Credit Card #......................................

LAST NAME………………………. FIRST NAME…………………………..

ADDRESS………………………………………………………………………
………………………………………………………………………

Signature…………………………… Date……………………………………..

FORM B DIRECT DEBIT MANDATE

I hereby authorize splashwin’s Fun Park until further NOTICE in wishing to Debit my
account the amount of $.......................... in respect of my annual subscription.

TO: The Manager Signature………………………….

Date……………………………….
Name of A/C………………………
Acct #...............................................

FORM B DIRECT DEBIT MANDATE

I hereby authorize splashwin’s Fun Park until further NOTICE in wishing to Debit my
account the amount of $.......................... in respect of my annual subscription.

TO: The Manager Signature………………………….

Date……………………………….
Name of A/C………………………
Acct #...............................................