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2. This online form is for membership at the Little Elm Recreation Center. Please read and complete all required fields listed below. If you are looking for membership forms for The Cove at the Lakefront™ or the combo pass for both the Recreation Center and Cove, then click on the link below.
4. The Cove at the Lakefront™ and Combo Membership Form
   The Cove at the Lakefront™ and Combo Membership Form
6. Little Elm Recreation Center Membership Agreement
8. Primary Contact on Account Information
10. First Name*
11. Last Name*
13. Street Number*
14. Street Name*
15. Apt #
17. City*
18. State*
19. Zip*
21. Phone Number*
22. E-mail*
24. Emergency Contact Information
26. First Name*
27. Last Name*
29. Relationship*
30. Phone Number*
32. List all Members on the Account
    Please include the information for the primary account holder
34. First Name*
35. Last Name*
36. Gender*

    1. Male
    2. Female
37. Date of Birth*
    Date of Birth
39. First Name
40. Last Name
41. Gender

    1. Male
    2. Female
42. Birthday
    Birthday
44. First Name
45. Last Name
46. Gender

    1. Male
    2. Female
47. Birthday
    Birthday
49. First Name
50. Last Name
51. Gender

    1. Male
    2. Female
52. Birthday
    Birthday
54. First Name
55. Last Name
56. Gender

    1. Male
    2. Female
57. Birthday
    Birthday
59. First Name
60. Last Name
61. Gender

    1. Male
    2. Female
62. Birthday
    Birthday
64. First Name
65. Last Name
66. Gender

    1. Male
    2. Female
67. Birthday
    Birthday
69. Type of Membership
    Please choose from the memberships listed below, as well as the payment option.
71. Type*

    Membership rates are listed in the table below.

    1. Individual (15-49 years)
    2. Family*
    3. Youth (2-14 years)

    1. Senior (50+)
    2. Pickleball
    3. Student** (18-22 years)
72. Payment*

    Please choose the frequency with which you will pay your membership

    1. Annual (Fee paid once per year)
    2. Monthly (Fee paid monthly)
74. *Immediate family members only, up to the age of 23. At 23, the member will be required to have his/her own membership.
75. **Student memberships only valid from May 15 - August 15 each year.
77. 
79. Membership Acknowledgement*

    I understand that once this form is submitted I will be contacted by the Little Elm Recreation Center within one business day to finalize my membership. I understand that I must provide payment before my membership is active. I agree to follow all rules, guidelines, and regulations put forth by the Little Elm Recreation Department and failure to do so may result in my removal from the facility. I may also contact the recreation center during operational hours to complete my membership activation by calling 972-731-3277.

    1. I understand and acknowledge the above statement.
81. Credit Card Information
83. Last Four Digits of CC#:*
84. Phone Number of CC Holder:*
86. Expiration Date:*
    Expiration Date:
    If no day is given, please put 01
87. Type of Card*

    1. VISA
    2. MasterCard

    1. Discover

    Please note we only accept these types of credit cards
89. Name as Printed on Card*
91. Credit Card Authorization*

    The Town of Little Elm is hereby authorized to draft my credit card, as listed above, on the due date of each month, or year for my monthly or annual Little Elm Recreation Center membership dues. I understand that my account will be paid by draft until such time as I provide written notification to the Little Elm Recreation Center to cancel this authorization.

    1. I understand the above statement and authorize this information to be kept on file for future use.
93. Waiver of Liability*

    For and in consideration of my/our participation in the programs, membership, and activities offered by the Town of Little Elm (hereinafter referred to as “the Town”), I hereby agree to release, acquit, hold harmless, forever discharge, and waive any and all claims that I/we may have against the Town of Little Elm, its officials, officers, agents, representatives, employees, and volunteers in whole or in part, in both their private and public capacities (hereinafter collectively referred to as “releasees”) from any and all actions, causes of actions, claims, demands, damages, lawsuits, costs, loss of services, expenses, and compensation, whether known or unknown, on account of, or in any way arising out of or connected in any manner with my/our participation in the activities, including, but not limited to, liability, damages, injury (including death), property damage, legal fees and/or costs caused by or related to any negligent or intentional act of releasee. I further agree pictures taken of me and/or the registrant during the activities may be used by the Town for promotional purposes in the activity guide, brochures, flyers, news releases, or the Town website. All cash or check refunds require a minimum of 6 weeks processing. Refunds will be mailed to account address. All class cancellations must be done 5 business days prior to the start of the class. All memberships paid in full will receive a prorated refund from the day the membership is cancelled.

    1. I understand and agree to the statement above.
95. Residency Verification*
    Please provide a picture of your driver's license or utility bill matching the name of the primary account holder to the address listed above. This will be used to verify residency before staff can finalize your membership.
Leave This Blank:


96. 1. Receive an email copy of this form.
97. Email address

    This field is not part of the form submission.

98. Submit

* indicates a required field