Work Requests

Caregiver passes, previously called babysitter passes, are assigned to a family. They can be used for child or adult care. These passes can be shared between multiple caregivers but only one caregiver can use the pass at a time. Caregivers must be accompanied by the residents for whom they care; caregivers cannot use the pass to enter the facility alone.

To receive a caregiver pass, you must complete an application and provide payment. Fill out the application below or, if you prefer, complete a paper application at the club office or the pool during regular office hours.

Pay by check or money order made payable to Hartland HOA or make an online payment (click here), subject to a small processing fee ($2.50).

Pool - Caregiver Pass
Name
Email
Phone (xxx-xxx-xxxx)
Hartland Address
Number of residents in their care
.
Names of residents receiving care.
.
Resident 1
Resident 2
Resident 3
Resident 4
.
WIth your electronic signature below, you confirm the following items are true. Further, you agree that this electronic signature is as valid and binding as a signature on paper.
.
I am a member in good standing of the Hartland Homeowners Association.
I agree that this Caregiver pass is good for one pool season only.
I agree to abide by all Hartland Swim Club Rules and Regulations.
I agree that I will not hold the Hartland Homeowners Association or any director, committee member or employee liable for any injury to person or loss of property, including death, at the pool or pool facilities.
I further agree that I will be solely responsible for the conduct of my family and guest while at the pool’s premises and accept liability for their actions.
.
Applicant signature (Full legal name)
Date signed
Optional Attachment
Description for File
Attach a File	Maximum File Sizes: 4 MB each Maximum Image Dimensions: 4100px