Recreation Center/Gate Entry Registration
NAME OF OWNER(S) / AUTHORIZED REPRESENTATIVE:

NAMES OF RENTERS USING THE FACILITIES:

ADDRESS 		 TELEPHONE 	 EMAIL		

GATE ENTRY:
Barcode(s) Desired (maximum of two) at $10 each: 	

Please note: Any additional or replacement barcodes, regardless of the reason for replacing, are $10 each.

If replacement needed:
Barcode(s) to Remain Active:				 Barcode(s) to Deactivate:				

RECREATION CENTER ENTRY:
Clubhouse Access Card(s) Desired (maximum of two) at $10 each: 	

GATE ENTRY: The barcodes for gate entry are limited to two (2) per household. Any additional or replacement barcodes, regardless of the reason for replacing, are $10 each.
RECREATION CENTER ENTRY: Clubhouse cards are limited to two (2) per household. Access cards are $10 each.

Please mail this form, proof of residency in the form of your rental agreement, and a check or money order, made payable to Remington CDD, to 219 East Livingston Street, Orlando, Florida 32801. Payments must be in the form of a check or money order to be accepted.

THESE BARCODES AND ACCESS CARDS MAY NOT BE PICKED UP AT THE OFFICE.

ACCEPTANCE:
I acknowledge the waiver as set forth on the attached page and agree to its terms. I have also read and agree to abide by the recreation center guidelines and pool guidelines.

Signature of Owner / Authorized Representative

Date

Signature of Adult Participant (Renter)

Date

WAIVER AND GUIDELINES

RECREATION CENTER GUIDELINES:
Fitness center equipment is reserved for adult use (over 18 years old)
Recreation center hours:
Monday – Sunday, 6:00 a.m. to 10:00 p.m.

POOL GUIDELINES:
Pool hours:
Monday – Sunday, dawn to dusk
For a complete list of pool rules, please refer to “Our Neighborhood’s Policies and Rules.”

WAIVER:
I understand that the Remington Community Development District assumes no responsibility for injuries or illness that I may sustain as a result of my physical condition or resulting from my participation in any activities, sports, use of exercise equipment, or other activities. I expressly acknowledge on behalf of myself and my heirs that I assume the risk for any and all injuries and illness that may result from my participation in these activities. I hereby release and discharge the Remington Community Development District, its agents, servants, and employees from any claims for injury, illness, death, loss or damage that I may suffer as a result of my participation in these activities. I understand that Remington Community Development District is not responsible for personal property lost or stolen while participating at the Remington Recreation Center, pool and sport facilities.

Signature of Owner / Authorized Representative

Date

Signature of Adult Participant (Renter)

Date

To be completed by District Office personnel:
Assigned Barcode Number(s):		

Assigned Clubhouse Card Number(s):