Hanarry Swim and Racquet Club

Membership Transfer Form

Date of this request ___________________________

Selling Member Number       ___________________________

Selling Member last name ___________________________

Selling Member Phone   ___________________________

Selling Member Contact Email  ___________________

New Member Name (Last, First, Middle Initial)____________________________________________

New Member Spouse Name (Last, First, Middle Initial)_____________________________________

New Member Address (Street, City, Zip)____________________________________________

New Member Dependent List

Date of Birth

Phone(s):          ________________________________           _______________________________

                                    Home                                                               Work

Email(s):           ________________________________

Date:                ________________________________

If referred by an HSRC member, please list:                  ________________________________

How did you find out about Hanarry Swim and Racquet Club?   _______________________________________

_______________________________________________________________________________________

I am the rightful owner of the above numbered membership and do hereby transfer the selling membership to the individual(s) identified above.  I recognize the existing $400 membership bond assigned to Selling Member family will transfer sole ownership to the individual(s) / family stated above and no monies from the bond transfer will be due the Selling Member.

Signed,            

________________________, Selling Member

Print  and complete this form and mail it to HSRC, PO BOX 294, Lilburn, GA 30048