Pool Only Sign Up

    Resident          Non Resident
Individual           $549                                      Individual                  $569
Senior Individual $519                                      Senior Individual       $549
Couple                  $579                                      Couple                     $599
Senior Couple $559                                      Senior Couple $589
Family       $599                                      Family                      $649
Senior Family    $599                                      Senior Family        $649
           (Prices do not include 7% Ohio Sales tax)
*JOIN by 4/10/2017 and SAVE $15

Membership Information

* Name:

* Date of Birth:

* Address:

* City:

* State:

* Zip Code:

* Email Address:

* Preferred Phone:

* Marital Status:

Spouse Information

Name:

Date of Birth:

Spouse Email:

Dependent Information

Name:

Date of Birth:

Name:

Date of Birth:

Name:

Date of Birth:

Name:

Date of Birth:

Membership Type

* Membership Type:

* Senior:

* Resident:

Add Grandparents to Membership?

Add Grandchildren to Membership?

Add a Nanny?

Nanny Name:

* Did a representative of Scioto Reserve assist you with your membership?

If so, please select representative:

Acknowledgement of Terms

I have read the term and conditions set forth in the Marquee Club Group Bylaws (which encompases Scioto Reserve Country Club) and agree to the terms and conditions within.

* Please Initial:

I understand that my membership will be limited to the only the pool season (5/24/17 to 9/4/17). During this time, I will have full member privileges to the pool and clubhouse at Scioto Reserve Country Club.

* Please Initial:

Club Charge Agreement

Monthly club charge payments are made via Electronic Fund Transfer (EFT). The payment will be deducted from your checking account or charged to your credit card account on, or about the 5th calendar day of each month.
Changes to an EFT information, including credit card number, expiration date, checking account, credit card account, etc, must be submitted in writing before the 20th day of the month to affect the next month's payment.
This authorization and any changes there to, must be at the club by the primary member or additional persons named on this membership. Club charge privileges may only be extended to primary or authorized members who have completed this form and designated family members.
There is a $25.00 fee for all EFT returns. A $10 fee for all declines on credit cards.
Each billing period will begin the first day of the month and end with the last day of the month.
Club charge privileges may be denied if the EFT is returned. Repeated returns and /or failure to pay the full amount due can result in the loss of club charge privileges, and the suspension or cancellation of membership, per the membership bylaws. The account may be referred to a collection agency if payment in -full has not been received within 40 days or the charge becoming due.
Member may access their membership and club charge account history through the club's web-site, www.sciotoreserve.com, by loggin -in with their membership number and PIN number, set forth below. Additional account inquiries can be made to the Club's accounting office at (740)-881-6500
If any charges or fees are past due 60 days those charges will be turned over for collection and will include full payment of the past due charges plus 30% in addition to any other reasonable attorney fees and cost of collection. The membership will be suspended until any past due payment is paid in full.

I HAVE READ, UNDERSTAND, AGREE WITH THE TERMS OF THIS AGREEMENT. PLEASE PRINT A COPY OF THE AGREEMENT FOR YOUR RECORDS.

* Please Initial:

Release of Liability

Please read before signing below.

In consideration of any and all participation in Scioto Reserve Country Club, LLC programs, activities, and use of facilities and equipment, the undersigned (1) agrees and understands that the risk of serious and permanent injury from the activities in The Club does exist; (2) knowing and freely assumes all risks, both known and unknown, even if arising from the negligence of the Releasees or others, and assumes full responsibility for participation and use of the facilities; (3) willingly agrees to comply with the stated and customary terms and conditions for participation; (4) agrees that if any unusual or significant hazard is observed, activities will be discounted and such matter will be brought to the attention of the nearest official immediately; and (5) for myself and on behalf of my heirs, assigns, personal representatives, and next of kin, hereby releases and holds harmless the Scioto Reserve Country Club, LLC, its owners, officers, agents and/or employees, other participants, and, if applicable, owners and lessors of premises (Releasees), with respect to any and all injury, disability, death, or loss or damage to person or property, including vehicles parked on premises, whether arising from the negligence of the Releasees or otherwise, to the fullest extent permitted by law.

I have read this release of liability and assumption of risk agreement; fully understand its terms, fully understand that I have given up substantial rights by signing it, and sign it freely and voluntarily.

* Signature:

Date:

Spouse's Signature:

Date:

For Parents/Guardians of dependents under the age of 23 (under the age of 22 at time of registration)

This is to certify that I, as parent/guardian with legal responsibility for this dependent/participant, do consent and agree to his/her release, as provided above, of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liability incident to my dependents involvement or participation in these programs as provided above, even if arising from the Releasees negligence, to the fullest extent permitted by law.

Parent's Signature:

Date:

Spouse's Signature:

Date:

Payment Information

Upon submitting your application, you will be prompted to enter payment information. By submitting this form you hereby authorize Scioto Reserve Country Club to immediately charge your bank account for the annual dues listed above.

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Pool Only Sign Up

Club Charge Agreement

Scioto Reserve Country Club • 7383 Scioto Parkway Powell, Ohio 43065 • (740) 881-9082 • Back to MarqueeClubGroup.com

the marquee Club Group. Three clubs that stand above all the rest.