One of Riverside Village Ponds

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PLEASE NOTE: Incomplete forms will be returned

Homeowner Name:

Homeowner Address:

Homeowner Telephone:

Email:

Please check the calendar first for availability

I/we request to reserve the pool clubhouse both for the following date(s):

1st Choice 2nd Choice: 3rd Choice:

Time needed: (such as noon - 4pm)


Refundable Cleaning/Damage Deposit Required: $100
The deposit will be returned if the premises are left clean and damage-free after inspection by the Pool Manager.
Rental Fee: Pool or clubhouse: $25 ~ Clubhouse and pool: $50

*Your reservation will not be held if the deposit is not received by the Pool Manager within 5 days of confirmation from Pool Manager of date/time requested.

By entering you name below constitutes your signature and your agreement to all rules and regulations of the pool and clubhouse.



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