I hereby apply for membership in the Pearl River-Nauraushaun Swim Club, Inc. I certify that I am at least 21 years of age and reside at the address shown above which is in the Pearl River Fire District, Pearl River School District, or the Town of Orangetown, NY. I understand that upon receipt of this application, proof of residency. It is my responsibility to keep the Club informed of any change in my address, phone number or email address.