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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 Town of Orangetown, NY. I understand that upon receipt of this application, proof of residency, and payment for $81.28, my name will be placed on a list of potential members. I understand that my application payment fee is non refundable. It is my responsibility to keep the Club informed of any change in my address, phone number or email address.