Seasonal Application — Lake Success Pool

Village of Lake Success

Park, Pool & Tennis — 2025 Season — Membership Application

Section 1 — Membership Selection

Resident Membership *

Individual — $165 Two — $330 Three or more — $500

Payment Method *

Check Credit Card

Family has a helper / aide

Section 2 — Family Contact

Family Last Name *

Phone *

Email *

Address *

Section 3 — Household Members

Section 4 — Waiver & Release

COVID Guidelines & Liability Release: I/We agree to abide by all rules and regulations of the Village of Lake Success Park, Pool & Tennis facilities. I/We understand that the Village of Lake Success assumes no responsibility for accidents or injuries. I/We release the Village of Lake Success, its officers, agents, and employees from any and all claims for damages. By signing below, I/We acknowledge that I/We have read and agree to all terms and conditions.

Section 5 — Family Guests (Optional)

Non-resident adult children, grandchildren, grandparents, and parents only.

Village of Lake Success

Staff Access Required

Staff Sign In

Application Details

Confirm