Non-Resident Membership Application

Highland Hills Non-Resident* Application
Step 1: Fill Out This Application Form
*(Highland Hills residents include those living in the subdivision and along Tuscora Rd., Bendemeer Rd. and on Robert Bruce Dr. between HH and the Dominion Power lines)

Step 1: Fill Out This Application Form

Full Name

Phone

Address

Zip Code

Additional Adult On Membership

Children's Names and Ages

Release and Waiver of Rights for Members

In consideration of my membership with the Pool and facilities at Highland Hills Community Corporation (a/k/a Highland Hills Community Association, hereafter referred to as the “Association”), I release, waive, discharge and hold harmless, the Association, its directors, officers, agents, volunteers and employees (hereafter referred to as “Releasees”) from any cause of action, claim, or demand of any nature, including, but not limited to, a claim of negligence, which I may now have, or may have in the future, against the Releasees, on account of personal injury, property damage, death, or accident of any kind, arising out of, or in any way related to ,my use of the Pool and facilities, however the injury or damage is caused, including, but not limited to, the negligence of the Releasees.

In consideration of my use of the Pool and facilities, I agree to release, waive, discharge and hold harmless, the Releasees from any and all causes of action, claims, demands, losses, or costs of any nature arising out of, or in any way related to, my child’s use of the Pool.

I certify that I have full knowledge of the nature and extent of the risks inherent in my use of the Pool and facilities, and I voluntarily assume the risks. I understand that I will be solely responsible for any loss or damage, including death, sustained by my child arising out of, or in any way associated with my child’s use of the Pool; and that, as witnessed by my signature to this instrument, the Association is released from any and all liability for such loss, damage, or death.

I further certify that I am in good health, and that I have no physical limitations or impairments which would preclude my safe use of the Pool.

I acknowledge that the Association is a non profit 501(c)(7) organization, in compliance with United States Internal Revenue Code, and statutes imposed by the Commonwealth of Virginia, and that nothing in this Release and Waiver of Rights shall be construed as a waiver of charitable non profit status and/or benefits designated by the Commonwealth of Virginia.

I agree to the terms & conditions

Highland Hills Non-Resident* Application Step 1: Fill Out This Application Form *(Highland Hills residents include those living in the subdivision and along Tuscora Rd., Bendemeer Rd. and on Robert Bruce Dr. between HH and the Dominion Power lines)

Step 1: Fill Out This Application Form

Pool Address - 8300 Greenock

Highland Hills Non-Resident* Application
Step 1: Fill Out This Application Form
*(Highland Hills residents include those living in the subdivision and along Tuscora Rd., Bendemeer Rd. and on Robert Bruce Dr. between HH and the Dominion Power lines)