St. Henry, OH · Mercer County
Single Pool Pass
The Single Pool Pass form collects a member’s contact and emergency information for a person obtaining a single pool pass.
What this form is
The Single Pool Pass form records the member’s name, address, phone numbers, emergency contact, and any allergies or medical problems. It also has spaces for a pass number, price, and cash or check payment details. The document does not state when the city requires it or explain where to submit it.
Who needs it
A person obtaining a single pool pass can use this form to provide member, emergency contact, and medical information.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is completed without a notary; it lists no notarized attachment or related step, so the signer just signs and dates it.
How to submit this form
- 1
Download The Form
Download the Single Pool Pass PDF.
- 2
Complete The Form
Provide the member’s contact information, emergency contact details, and any allergies or medical problems.
- 3
Add Pass And Payment Details
Complete the pass number and price spaces and indicate cash or check details as applicable.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What information does the Single Pool Pass form ask for?
- It asks for the member’s name, address, home and work phone numbers, emergency contact and number, and any allergies or medical problems. It also includes spaces for pass and payment details.
- Do I need a notary for the Single Pool Pass form?
- No. The document does not include a notary block or list any notarized attachment or related step; the signer just signs and dates it.
- How do I submit the Single Pool Pass form?
- The form does not give submission instructions. Submit it to the city department named on the form; check the city website for current contact details.