ST. VRAIN LAKES METROPOLITAN DISTRICT NO. 1 - ADDITIONAL AUTHORIZED USER FORM

All adult Additional Authorized Users must complete this form, be listed on a Property Owner Form, AND sign a Release Form in order to access the Recreation Amenities.

ADDITIONAL USER INFORMATION:

Name

Phone Number

Residence Address

Relationship to Property Owner: (Examples: Tenant/Renter, Nanny, Grandparent/Grandchildren)

E-mail Address(s) for contact purposes

2nd Person Name

Phone Number

Residence Address

Relationship to Property Owner (Examples: Tenant/Renter, Nanny, Grandparent/Grandchildren)

E-mail Address(s) for contact purposes

Emergency Contact (Not Immediate Family)

Emergency Contact Phone Number

NOTE: Minors must be accompanied by a Property Owner or another Additional Authorized User unless a Minor Release Form is on file with the District Manager.

MANDATORY INFORMATION ON PROPERTY OWNER AUTHORIZING USE

Address of Property Owner Authorizing Use (Must be in-District)

Owner Name

Owner Phone Number

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