Marco Island Racquet Center
City of Marco Island Parks and Recreation
50 Bald Eagle Drive Marco Island Florida 34145
(239) 394-5454
Annual Membership Application
Make checks payable to the City of Marco Island.
I agree to indemnify and hold harmless the City of Marco Island and any and all
employees of the City of Marco Island against any and all claims by or on behalf of any
person or legal entity arising from the Participants use of premises, and will further
indemnify and hold harmless the City of Marco Island, its Department and employees,
against performance of any agreements on the Participant’s part, or arising from any act
of negligence of the Participant, or any part of the Participant’s agents, contractors,
employees or licensees, and from and against all costs, attorney’s fees, expenses and
liabilities incurred in or about any claim or proceeding brought thereon, all to the extent of
the city’s liability under general law. The City reserves the right to deny registration, and
to charge a fee where applicable, the Participant must adhere to all City Ordinances,
Parks and Recreation and Racquet Center Rules and Regulations.
X________ _ ____ Date
/ /
OFFICIAL USE ONLY (STAFF)
Type of membership:
Junior
New
Renewal
Returning Member
Expiration Date__________________
Amount Paid $_______________________
Cash: $____________________________
Check #____________________________
Credit Card: $________________________
Staff Signature: ______________________________
Entered in Book (date) ________________________
Entered in Computer (date) _____________________
Signature of Participant(s) or Parent/Guardian if less than 18 years of age
Name(s) ________________________________________________________________________________________
Local Address____________________________________________________________Zip Code______________
Home #______________________________________________Cell #______________________________________
Other Address, Zip Code, Phone #_______________________________________________________________
Email address: ___________________________________________________________________________________
Emergency Contact Person__________________________________________Relationship_____________________
Emergency Contact Home #______________________________________Cell #______________________________
