Application for Membership

First Name

Last Name

Spouse (if applicable)

Primary Phone

Children Names & Ages (if applicable)

Primary Address

Address

City

State

Seacrest Beach Club Street Address

Rules & Regulations

I agree to adhere to the By-laws and Rules & Regulations of Seacrest Beach Club

INSTRUCTIONS: Beach access requires a family flag, which will have a white background. Please choose a color for the letters of the family name on the flag.

Color

Family Name to Appear on Flag

MEMBERSHIP FEES: There is a one time initiation fee of $300.00 plus a $60.00 fee for a flag and staff. Please mail a check with a confirmation of the last name on this application to: Seacrest Beach Club, PO Box 1032, Lavallette, NJ 08735

I agree to send a check totaling $360.00 within thirty (30) days of submitting this application for membership

Signature

Date