Wait List Application

Add information about your waitlist here.

  • MM slash DD slash YYYY
  • Enter the name of the person who should be contacted regarding any questions about the account.
  • A regular membership may only be issued to the head of household. A household is defined in the PRNSC bylaws as a family permanently living together consisting of a head of household, spouse, all unmarried children who have not turned 21 by July 1 of the current year, and all adult dependents living in the household who are not self-supporting because because of a permanent disability. Associate memberships are available to children of the household that are over the age of 21, a mother, father or mother-in-law or father-in-law not gainfully employed and living permanently with the regular member.
    Please check off the type of membership you are interested in applying for.
  • This is what you will use to log into your waitlist account.
  • Strength indicator
    Select a password that you will use to access your account. You will be able to send a password reset link to the email address you entered above if necessary.
  • American Express
    Discover
    MasterCard
    Visa
    Supported Credit Cards: American Express, Discover, MasterCard, Visa
     
  • Application fee: $75.00+ tax (8.375%)
  • $0.00
  • 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.