Caretaker Permission Form 
All caretakers/babysitters must have a permisson form while in the pool area.  You can either print out this page or you are welcome to download a pdf version (see link below).  If you have any questions, please contact the board via email at: board@westchestercommons.net

Westchester Commons Caretaker Permission Form

(Please PRINT all information)

(ALL Information is Required)


Date: ________ / ________, 20_______

Name of Homeowner: _______________________________________

Address: _________________________________________________

Day Phone: _______________________________________________

Evening Phone: ____________________________________________

E-mail: ___________________________________________________

I hereby give, _________________________________________________ permission to use my assigned key fob while caring for a member of my family that resides at the address shown above. The name(s) of the family member he/she will be caring for is: _________________________________________________________________________ .

By signing below, I affirm that the above mentioned caretaker/babysitter does not currently reside in Westchester Commons. (Note: If he/she does reside in the subdivision then he/she must use their own key fob to gain access. Non-Recreational Level members living in Westchester Commons are NOT permitted in the pool area, even if they are being paid as a caretaker by you, a member).  

I understand that the caretaker/babysitter must have a valid I.D. on them while in the pool area, showing their name and address. They must present this I.D., if asked.  Additionally, I affirm that I have provided a copy of the pool rules to the caretaker/babysitter.

The above mentioned caretaker/babysitter has permission to use my key fob on the following date(s): ______________________________     ________________________________

______________________________     ________________________________

_____ All pool season   

     
Signature of Member: ____________________________________________

PLEASE PRINT OUT THIS FORM, FILL IT OUT AND GIVE IT TO THE CARETAKER/BABYSITTER. HE/SHE MUST HAVE THIS FORM WITH THEM AT ALL TIMES WHEN IN THE POOL AREA.


 To download a pdf version of this form, click here. 

    Westchester Commons Swim & Tennis Association, Inc. in partnership with AMAG, Inc.