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HOMEOWNER
WELCOME PACKET
Plantation Lakes Homeowner’s Association
29787 Plantation Lakes Blvd. Millsboro, DE 19966
TABLE OF CONTENTS
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A Note from Management – Welcome Home .................................................................... 4
Quick Reference Directory ...................................................................................................... 5
Welcome Packet Purpose ....................................................................................................... 5
Welcome Committee ............................................................................................................... 6
Utility Services Prior to Closing Date ..................................................................................... 6
Trash .......................................................................................................................................... 6
Cable TV & Internet................................................................................................................. 7
Post Office ................................................................................................................................. 7
Department of Motor Vehicles ............................................................................................... 7
HOA Information .................................................................................................................... 8
Office, Website, Newsletters ............................................................................................... 8
Monthly Association Payment Information ........................................................................... 8
Automatic, Recurring Monthly Payments .......................................................................... 8
Additional Options ............................................................................................................... 9
Community Center Information ............................................................................................. 11
Golf Facility ................................................................................................................................ 12
Architectural Review & Covenants Committee ..................................................................... 13
Town of Millsboro .................................................................................................................... 14
Water & Sewage .................................................................................................................... 14
Second Water Meter/ Irrigation Sprinkler Systems ......................................................... 14
Community Recreation Center Rules & Regulations ........................................................... 15
Flex Room Rules & Regulations ............................................................................................. 16
Flex Room Personal Use Agreement ..................................................................................... 18
Pool Rules & Information ........................................................................................................ 19
APPENDIX (Files, Forms, Agreements)
Amenities User Agreement ..................................................................................................... 20
Community Center & Pool Application Form ........................................................................ 21
BB&T Association Pay ACH Authorization Form .................................................................
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A NOTE FROM MANAGEMENT
Welcome Home
Dear Plantation Lakes Resident,
We wish to extend a warm welcome to you as a new resident of Plantation Lakes. Our
Association is very active and we work hard to maintain an attractive quality of life within the
community, as well as protect the value of your home. It is our sincere wish that your
Association with Plantation Lakes will bring you immense enjoyment through great
experiences.
ICON Management has the experience, knowledge, and training necessary to operate and
maintain your community to the highest of standards. Our staff members are well-oriented
individuals who will work closely with you, your Board, and subcontractors to help make your
experience in the community as enjoyable as possible.
The information in this packet is provided to make you feel at home and informed from day
one. Enclosed you will find information that is intended to make the adjustment to your new
home a seamless transition.
Again, welcome to Plantation Lakes. We are delighted you have chosen us and hope that you
and your family will enjoy yourselves for many years to come.
If you have any questions, comments, or concerns, don’t hesitate to contact us via email at
[email protected], or by calling the HOA Office at 302-934-5200.
Kindest Regards,
The ICON Management Team
Plantation Lakes Homeowner’s Association
29787 Plantation Lakes Blvd.
Millsboro, DE 19966
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PLANTATION LAKES DIRECTORY
Community Association Manager: Richard Brucki [email protected] 302.934.5200
Community Association Assistant: Marianne Dolente
[email protected] 302.934.5200
Club Manager, Director of Golf: Brian Fedish
[email protected] 302.933.8072
Head Golf Professional: Ian Madinger
[email protected] 302.933.8072
Golf Course Superintendent: Nicholas Larrimore
302.545.6547
ICON Management Corporate Office: Michael Fleming- [email protected] 941.747.7261
Lennar Customer Care Chris Clark [email protected] 800.532.6993
Electric Company Delaware Electric
Cooperative
delaware.coop 302.349.9090
Internet & Cable Provider Mediacom mediacomcable.com 855.633.4226
Trash Collection Waste Management wm.com 443.226.2836
Waste Water Town of Millsboro millsboro.org 302.934.8171
Gas Company Chesapeake Utilities chpkgas.com 800.427.0015
Fire Department- Non Emergency
Millsboro Fire Company millsborofire.com 302.934.8359
Police Department-Non Emergency Millsboro Police
Department
millsboropd.com 302.934.8174
Post Office Millsboro
Post Office
usps.com 302.934.9226
Library Millsboro
Public Library
millsboro.lib.de.us 302.934.8743
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PLANTATION LAKES COMMITTEES
Welcome Committee Committee Elena Ripkin [email protected]
Architectural Review Committee Bill Moler [email protected]
Community Cares Committee Jim Kells [email protected]
Events Committee Joyce Neumann [email protected]
Seasonal Decorations Committee Joyce Neumann [email protected]
Plantation Lakes Garden Club Debbie Darr [email protected]
Welcome Reception
The Welcome Committee periodically sponsors a welcome reception/happy hour for new
residents at the Plantation Lakes Clubhouse. Receptions are intended to provide an
opportunity for homeowners to obtain information about the Plantation Lakes community
and the surrounding area. Invitations are sent out by email to new residents prior to the
reception date and an rsvp is requested.
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Utility Services
We recommend that homeowners contact all service providers by phone prior to the closing
date of their home to ensure minimal delay in installation.
Trash
Contact the HOA office at the Community Center to schedule delivery of trash can & recycle
can and for missed pick-ups. Trash is picked up every Thursday. Recycling is picked up every
other Thursday. In the event of a missed pick-up, please contact the HOA office. Pick-up is
delayed by one (1) day during a major holiday week.
Cable TV and Internet – Mediacom: 855.633.4226
32441 Royal Blvd, Dagsboro, DE 19939
Residents may only install antenna and/or satellite dishes that adhere to community guidelines.
Please refer to the Community Design Guidelines for information.
Millsboro Post Office – 302.934.9226
100 Main Street, Millsboro, DE 19966
o Monday – Friday 9 a.m. – 5 p.m.
o Saturday - 9 a.m. – 1 p.m.
New Residents can obtain a Change of Address form there or access it online.
Delaware Department of Motor Vehicles – 302.853.1000
23737 Dupont Blvd., Georgetown, DE 19947
All new Delaware residents must obtain a Delaware driver’s license and registration within 60
days of moving to Delaware.
Requirements to register vehicles in Delaware:
o Birth Certificate and/or Passport
o Social Security Card – (Must be original, not a copy) or Current W-2 or 1099
o Current Driver’s License
o Current Registration
o Delaware Insurance Card – must be insured in Delaware prior to going to DMV
o Two (2) current pieces of mail sent to Delaware address such as a utility or cable bill (not
personal mail).
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Homeowner’s Association Information
HOA Office – 302.934.5200
The HOA office, managed by ICON Management Services Inc., is located in the Community
Center. Office hours are Monday – Friday 9:00 a.m. – 5:00 p.m. Visiting hours are Monday
& Friday 2:00 pm – 4:00 pm, Tuesday & Thursday 11:00 am – 1:00 pm.
Website – plantationlakesclub.com
Plantationlakesclub.com contains information about various payment methods, community
updates, and documents and forms that are only available to homeowners. Homeowners log in
using their email address and a password provided by an HOA representative.
Newsletters - The Community Association Manager sends e-blasts and monthly email
newsletters which contain important community updates like news, events, or other helpful
information. A request to register can be completed on the plantationlakesclub.com or by
contacting the HOA office directly.
MONTHLY ASSOCIATION PAYMENTS
New homeowners will receive a coupon booklet in the mail which contains the necessary
credentials to set up automatic recurring payments online. Upon receipt of a coupon booklet
containing account numbers used to login, homeowners may register for Automatic Clearing
House payments at BB&T. Questions regarding payments and the status of an assessment
account and additional inquiries may be directed to the HOA office.
PAYMENT METHODS
Automatic, Recurring Monthly Payments (Recommended)
With BB&T Association Pay (ACH), homeowners can have recurring payments debited
directly from their checking or savings account held at any US financial institution.
Enroll online at BB&T Association Pay (ACH).
Enroll online through the 25th of each month to be effective for the next debit month.
Payments are deducted on the third of each month.
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Enroll by mail or fax by completing the Association Pay enrollment form in the coupon
booklet or following the instructions in this Generic Enrollment Form (PDF).
Manage Association Pay
To update an account, use the Change Form (PDF).
To stop an automatic payment, use the Cancel Form (PDF).
Download the Association Pay Deadline Calendar (PDF) to find the deadlines for setting up,
changing or canceling the next payment.
Additional Options:
Pay now online
To make a one-time payment, use the BB&T Online Payment System (opens in a new
window).
Online Payment Options:
Pay by debit or credit card with Visa®, MasterCard®, American Express® or Discover
card. A convenience fee of 2.95% of the transaction amount is charged for payments
made online by credit card. A flat $4.95 convenience fee is charged per transaction for
payments made online by debit card.
Pay by eCheck with a one-time electronic funds transfer by ACH debit from a checking
or savings account from any US financial institution. No convenience fee is charged for
payments made by eCheck.
Pay with bill pay
Schedule an association payment through a homeowner’s bank's bill pay service or other
online payment bill pay processor. Please refer to the Association Services coupon booklet for
important instructions on using an online bill pay service.
Ensure the online bill pay setup reflects the following:
Payee Name: Plantation Lakes Homeowners Association
Payee Address: PO Box 628207, Orlando, FL 32862-8207
Payee Phone: 888-722-6669
Account Number: On each scheduled payment, use the bill pay account number that appears
on the association payment coupon. Do not add any other letters, numbers or identifying
words in the account number area.
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When are online bill payments received?
In most instances, payments are not received on the same day that funds are debited from
homeowners’ accounts. Depending upon the method of payment and delivery used by the bill
pay provider, payments may take up to 5 business days or more to be posted to the
Homeowner’s Association’s account. When using a bill pay service, it's recommended to
schedule payments for a date well in advance of the due date.
Pay at a BB&T branch:
BB&T has more than 2,100 branches to serve homeowners. Take the Association Services
coupon booklet along with payment to any BB&T location.
The nearest BB&T branch is 16 miles away in Berlin, MD:
11111 Racetrack Rd, Berlin, MD 21811
(410) 641-5265
Mail Payment with Coupon to:
BB&T
PO Box 628207
Orlando, FL 32862-8207
Do not mail cash.
Homeowners must include an Association Services coupon with every payment.
Make checks payable to "Plantation Lakes Homeowners Association."
Write the Bill Pay Number (located on the top of each coupon) on each check.
Write "US Funds" on Canadian checks that are to be processed in US funds.
For your convenience, mailing labels are included in the coupon book.
Please Note: Non-payment correspondence received by BB&T at this address may be
destroyed.
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COMMUNITY CENTER Access cards
Access cards are required to enter the Community Center outside of normal office hours. To
register and receive your access card(s), homeowners may schedule an appointment or stop by
the HOA office to obtain up to two (2) access cards. In the event that a homeowner loses an
access card, a $10.00 fee is instituted in order to replace it and the lost card’s access is denied
remotely.
Fitness Center
Access cards are required to use the fitness center outside of normal office hours. Sanitary
wipes are available in each fitness room for wiping down equipment before and after each use.
Flex Room
The Flex Room is only available for the use of Plantation Lakes Residents and their guests. In
order to reserve the Flex Room, residents must contact the HOA office. If reserving the Flex
Room for an event open to the community, a payment is not required to use the room. A
$100.00 security deposit is required for private events. Please refer to the fee schedule to
determine the rental fee. A Flex Room Use Agreement must be completed along with the two
checks made payable to “Plantation Lakes HOA” in order to reserve the Flex Room. If there
are cleaning charges or damages following the event, the security check is deposited; otherwise,
the check is shredded or returned upon request after the event is held. The Flex Room User
Agreement and Rules are enclosed in this packet.
Community activities are held on a regular basis in the Flex Room. Please check our website
and email newsletters for updates.
Free Wifi
Wifi is only available in the Community Center.
Name: plantationlakescommcenter
Password: Community
Swimming Pool
The swimming pool is open from the Saturday prior to Memorial Day until just after Labor
Day. The Pool Rules and Information are enclosed in this packet. Residents may stop by the
HOA office to obtain a silicone wristbands to be used by each family members who resides full
time in Plantation Lakes. If a resident loses a wrist band, there is a $50.00 replacement fee to
replace it. New homeowners will receive one (1) complimentary guest pass which is good for
five (5) uses. Additional passes may be purchased at a cost of $10.00 per pass.
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GOLF FACILITY
Golf Professional Brian Fedish is available to answer golf related questions, comments, or
concerns. Residents and their guests are welcome to visit the Golf Shop and Snack Bar. Visit
plantationlakesclub.com/course for more information about the golf facility such as hours of
operation, news, updates, greens fees, information about professional instruction, and more.
Golf Benefitted-Members receive a Welcome Pack and an Annual Golf Guide outlining
events, player development programs, leagues, as well as the club’s code of conduct.
Plantation Lakes Golf & Country Club
30066 Charlotte Blvd. Millsboro, DE 19966
Phone: 302.933.8072
Email: [email protected]
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HOA ARCHITECTURAL REVIEW &
COVENANTS COMMITTEE
Prior to any exterior modifications to a home or lot, a Design Review Application must be
submitted to the HOA office the Friday before the Committee meeting.
Design Guidelines and Design Review Application
Applications are available in the Community Center hallway outside the HOA office and on
the plantationlakesclub.com website. The Committee is comprised of nine (9) residents
selected by the HOA Board of Directors. It meets on the 3rd Tuesday of each month to review
the submitted applications. All applications must be received by the HOA office the Friday
before the scheduled meeting.
Once the Committee determines that all proposed changes are in compliance with the Design
Guidelines, the Board of Directors then reviews the recommendations of the Committee.
After the Board has reviewed all the applications, homeowners will be notified by letter via
email from the HOA management office of their decision.
All Design Review Applications require a $25.00 application fee. Homeowner’s can put as
many design review requests as needed on one (1) application for the set fee of $25.00.
Payment must be by check only made payable to “Plantation Lakes HOA.”
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TOWN OF MILLSBORO
322 Wilson Hwy., Millsboro, DE 19966
Phone: 302.934.8171
Hours: Monday – Friday: 8:00 a.m. – 4:30 p.m.
Website: www.millsboro.org
Water & Sewage
The Town of Millsboro bills on a quarterly basis (January, April, July, and October). Meters
are read manually (Ref: Millsboro Town Code 206-15, Reading Meters). The town’s billing
policy is that a property owner is billed a minimum of $90.00 per quarter that takes into
account the first 7500 gallons used (current rate is $1.20 per 100 gallons used) whether 7500
gallons is used or not. If an owner uses more than 7500 during the billing period, then the bill
is for the actual amount used, for example, 10,000 gallons used would result in a bill of
$120.00 (10,000 ÷ 100 x 1.20). For new property owners, upon request to the town office, the
town will consider waiving the first billing if the billing period is less than 30 days.
Second Water Meter/Irrigation Sprinkler Systems
Many property owners will have a second water meter installed for water used on the outside
water spigots and an irrigation system (Ref: Millsboro Town Code 206-9, Separate Meter for
Irrigation Sprinkler Systems). We recommend installing a second water meter because the
town does not apply the sewer charge ($1.02 per 100 gallons used) to the water used and lawn
watering is a necessity, particularly in the summer. The second water meter must be purchased
by the property owner from the town ($180.00). The property owner is responsible for the
installation ($400-$500) by a licensed plumber and for notifying the town office after
installation is completed. There is at least one company that will include the second meter
installation as part of their cost for installing an irrigation system.
Local Businesses & Area Attractions
The Millsboro Chamber of Commerce maintains a list of local businesses on their Business
Directory, as well as area attractions, Parks & Recreation, outdoor venues, etc. Please refer to
their website at www.millsboro.org.
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COMMUNITY RECREATION CENTER
RULES & REGULATIONS This publication sets forth the policies and rules for use of the Community Center.
1. The Fitness Center is reserved for residents of Plantation lakes only.
2. A parent or legal guardian must accompany persons under the age of 18 years at all times in the
Community Center.
3. Individuals under the age of 18 are restricted from using the fitness equipment without an adult
accompanying them in the Fitness Centers.
4. Parents are reminded that the equipment can pose a health and safety hazard to younger children.
Please refrain from allowing them to play on or near the equipment.
5. Proper attire is required.
6. Please be sure to wipe off the equipment following your use of it. Gym wipes are provided.
7. Pets are not allowed in the exercise and/or food areas.
8. Alcohol, glass drink containers, and food are prohibited in the exercise areas.
9. Music players may be only be used with earphones, at a volume that does not disturb others.
10. Fitness Center hours of operation are 5:00 AM until 11:00 PM.
11. Changes to the Fitness Center Rules are at the sole discretion of the Plantation Lakes HOA Board of
Directors.
12. Owners use the Recreation Center at their own risk.
13. The Association, the Board of Directors, the Developer, its agents or assigns assumes no responsibility
for any accident or injury in connection with such use or for any loss or damage to personal property.
14. Management reserves the right to deactivate access to members not in “good standing”.
15. In case of emergency call 911.
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FLEX ROOM RULES & REGULATIONS This publication sets forth the policies and rules for use of the Flex Room.
1. Users of the Flex Room will be responsible for any damage to the facility done by them or their guests.
2. Guests are not allowed to enter the exercise areas.
3. Trash must be removed from the Community Center following use, or the user’s deposit will not be
refunded. Trash containers are available in the parking lot adjacent to the basketball court.
4. All tables and chairs that are Plantation Lakes property must be returned to the storage room
immediately following each event.
5. The Flex Room must be cleaned following use.
6. Entrance doors are not to be propped open.
7. Emergency exits must not be blocked.
8. Smoking is prohibited in the Community Center and within 20 feet of the building.
9. It is requested that clear beverages are used for children’s events rather than cola or red/blue juices.
10. Decorations, if used, are to be taped up to metal or glass surfaces rather than any painted surfaces.
11. Confetti is prohibited. Balloons are prohibited.
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POOL RULES & INFORMATION
FOR USE OF THE FACILITIES This publication sets forth the policies and rules for use of the pool and pool deck area.
Pool Operation Period: Saturday May 25th
through Sunday September 15th
(subject to adjustment by the
Board of Directors).
Hours: 10:00 a.m. – 8:00 p.m.
Pool Rules: Owners and their guests use the pool facilities at their own risk. The Association,
the Board of Directors, the Developer, its agents or assigns assumes no
responsibility for any accident or injury in connection with such use or for any
loss or damage to personal property.
Administrative Procedures:
Each address will initially receive up to two (2) access cards, and one silicone wristband to be used by each
family member who reside in Plantation Lakes.
Access cards will be deactivated by management for homeowners that are delinquent on their assessments or
after a hearing where the Board of Directors finds the homeowner in violation of published regulations.
You must keep your Access card from year to year. There is a $10.00 replacement cost fee for any lost, stolen,
or erased cards, note: cards can be erased remotely.
Silicone wrist bands will be replaced in kind for a snapped wristband. A fifty dollar ($50) replacement cost is
required to replace a lost wristband.
Pool Entry:
Entry to the pool will be made through the pool gate located near the basketball court and tot lot
playground via your access card. All members of your party will be identified by the appropriate
wristband being on their person; be it homeowners with the Plantation Lakes silicone band, and/or
your guest that will present their guest pass to the attendant or Community Association Manager who
will punch the card and issue a color coded Tyvek-paper wristband, or a two (2) color silicone
wristband which will be valid for the day and returned to the attendant or the Community Association
Manager at the end of the swim session.
New Homeowners will receive one (1) complimentary guest pass which is good for 5 uses. Additional
passes may be purchased at a cost of $10 per pass. Payment must be made by check or money order
only. Cash will not be accepted. A guest must be accompanied by a key card holding resident while in
the pool area.
Guests are defined as person(s) who do not reside in Plantation Lakes.
Tenants are defined as persons(s) who have an active lease agreement with a Record Owner at
Plantation Lakes HOA. A copy of the active lease agreement must be on record with the Managing
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Agent and the Record Owner must be in good standing with the Association prior to a key card being
released to a tenant.
Members are responsible for their guests.
Pool Rules and/or hours of operation are subject to modification and/or change by the Board of
Directors. Changes to the Pool Rules and Regulations are at the sole discretion of the Board of
Directors of Plantation Lakes HOA as per Plantation Lakes HOA Bylaws Article VII Section 1(a).
Children under the age of six (6) do not require a wristband as they shall be assumed to be with the
parent or guardian.
Operational Policies:
1) The pool is open for swimming from 10:00 a.m. to 8:00 p.m.
a. The pool is closed for swimming if:
b. Thunder or lightning, is in the area.
c. Equipment breaks down.
d. Fecal contamination.
2) Children under the age of 15 must be accompanied by a parent or guardian.
3) Children under the age of six (6) must stay within arm’s reach of their parents at all times while in and
around the water.
4) Alcohol and glass drink containers are prohibited. Only plastic bottles are allowed.
5) Cooking or grilling in or around the pool is prohibited.
6) No diving is permitted.
7) The Association required that children not toilet trained wear a swim diaper covered by tight fitting
waterproof pants in the pool. No changing of diapers on the pool deck is allowed. Diaper changing
areas are available in the locker rooms.
8) Pets are prohibited in the Community Recreation Center swimming pool areas except for Disability
Assistance Dogs.
9) Smoking is prohibited in the Community Recreation Center and the swimming pool areas.
10) Radios, CD players, iPods and MP3 players may be played only with earphones, or at a reasonable
volume that doesn’t disturb others.
11) Running and/or roughhousing around the pool is prohibited.
12) All life vests used must be Coast Guard Certified.
13) Balls, inflatables such as inner tubes, rafts of any kind and any other device(s) are only allowed at low
use periods of time.
14.) Chairs may not be reserved for persons who leave the pool area or who are expected to arrive later.
They are available on a first come, first serve basis. Please return chairs to their original positions and
clean area around you before leaving the pool area.
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15.) Proper respect and cooperation is due to the Pool Attendants.
16.) For the protection of all residents, admission to the pool area may be denied for persons with open
lesions, sores, infections, or contagious conditions.
17.) Swimsuits that are wet are not permitted in the Community Center.
18.) The Attendant may demand any patron leave the pool area if the rules are not being followed, the
Attendant will inform the Community Manager at a later date.
19.) Lane lines (1-2) may be installed and removed by anyone wishing to use the lane lines.
20.) No chairs are allowed in the pool.
Disclaimer of Liability: All persons making use of the Pool and Clubhouse and Guest pass privileges and using any of the Community Area recreational facilities agree to abide by the rules and regulations for use of
the facilities. Use of facilities is at the user’s sole risk and responsibility.
The Association and the Declarant so not assume responsibility for any occurrence, accident, or injury in connection with such use. No owner shall make any claim against the Declarant and
the Board of Directors, the Association, their servants, agents, or employees, for or on account of any loss or damage to life, limb or property sustained as a result or in connection with any
such use of any of the recreation or common facilities. Each Owner shall hold the Declarant, the Board of Directors, the Association and Managing Agent harmless from any and all liabilities
and any action of any nature by any tenants, guests, invitees or licensee of such Owner growing out of the use of the recreational or common facilities, except where such loss, injury or
damage can clearly be provided to have resulted from and been proximately caused by the direct negligence of the Board, the Association or their agents, servants or employees in the
operation, care or maintenance of such facilities. Any damage to the building, recreational facilities, or other Community Areas or equipment caused by an Owner or such Owner’s guests
shall be repaired at the expense of the Owner.
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PLANTATION LAKES HOMEOWNERS ASSOCIATION
AMENITIES USER AGREEMENT
I, ______________________________________________________________________, Owner/Tenant of
_______________________________________________________________________________________
at Plantation Lakes Community, hereby certify that I have received, read and agree to comply with all
provisions of Policy Code: “Pool Rules”, as well as all provisions of the other policy Codes.
I further agree that my use of the Swimming Pool Area/Pool and its related facilities is generally on an
unsupervised basis and is at my sole risk, responsibility and liability. I hereby agree on behalf of myself and my
guests to indemnify and hold free and harmless the Declarant, the Association, the Board of Directors, and
Managing Agent from any and all claims of any nature arising from my use of the Pool and Club House and its
related facilities.
I hereby accept full responsibility for any damage to Pool and Club House and its related facilities. I
have also relayed this information to all members of the household and will review it with any guests I bring to
the pool.
_______________________________________________________________________________________
Signed: Date:
_______________________________________________________________________________________
Signed: Date:
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PLANTATION LAKES HOMEOWNERS ASSOCIATION
COMMUNITY CENTER & POOL APPLICATION
Settlement Date:__________________________________________________________________________
Please Print Legibly: Date: ____________________________________________________
Homeowner’s Name(s): ____________________________________________________________________
Resident (if different from owner): ___________________________________________________________
Address: ________________________________________________________________________________
Other Address (part time residents): __________________________________________________________
_______________________________________________________________________________________
Home Phone: ___________________________________ Cell: ___________________________________
E-mail address: __________________________________________________________________________
E-mail address: __________________________________________________________________________
Note: Each address will initially receive two (2) Access Cards. There is a $10.00 replacement cost fee for any
lost or stolen cards.
Please complete the information below for all full time resident occupants requiring access to the pool.
Name(s) of All Living in Household Birth Date (Child Only) Access Card #
First, Last Month, Day, Year
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In case of emergency please contact: (Outside Household):
Name: ______________________________________________ Relationship: ________________________
Address: ________________________________________________________________________________
Home Phone: _________________________ Work Phone: _________________________
Cell Phone: _________________________
Notes:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________.
Read and Sign.
Pool passes will not be issued to anyone who is not in good standing with the Association.
No one will be admitted without a pass and there will be no exceptions.
All persons using the pool or pool facilities do so at their own risk. The Plantation Lakes Homeowners
Association assumes no responsibility for any accident or injury in connection with such use or for any loss or
damage to personal property. Note: I have read the Rules and Regulations governing the use of the swimming pool facilities and all other amenities, and I agree to
abide by all the rules set forth.
Signature (Homeowner): ______________________________________________ Date: _________________________________
Signature (Homeowner): ______________________________________________ Date: _________________________________
Signature of Tenant: __________________________________________________ Date: _________________________________
Signature of Tenant: __________________________________________________ Date: _________________________________
