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King Farm Amenities Pass Application Form

Please complete the following fields and then select Submit. Your submission will be sent directly to Management. We strive to respond to messages as quickly as possible; however, please allow 1 to 2 business days to receive a response. Once your information is verified, we will contact you to let you know that we have issued the mobile amenities passes. If there is information missing, we will contact you to let you know.

Resident Type(Required)

Please indicate whether you are the owner or tenant. If you are a tenant, please include your lease by uploading a file at the end of this application.

Applicant – Resident #1 Name(Required)

Main homeowner or tenant information.

First Last

Resident #1 Email Address(Required)

Resident #1 Phone Number(Required)

Please provide your contact number in case we need to call you.

Homeowner/Resident #2 Name(Required)

If there is only 1 owner/tenant, please put N/A in the fields below for resident #2. If there are multiple homeowners or members of the household, please list their information AND list each person in the home (including yourself) in the space provided under “Additional Members of Household”.

First Last

Resident #2 Email Address(Required)

Secondary homeowner or tenant. If there is only 1 resident in the household, please put N/A.

Resident #2 Phone Number(Required)

Address

King Farm Address(Required)

If you live in a condominium, please be sure to include your unit number in the space below.

Street Address Address Line 2

Mailing Address (off-site owner)

If you are an off-site owner and do not reside in King Farm, please provide your mailing address.

ADDITIONAL MEMBERS OF HOUSEHOLD:

Please list ALL members of your household (including yourself) and include each persons name, age, and relationship to you. In the space below you may indicate if all members need amenities passes or if only certain individuals do. Children 12 + are eligible for an amenities pass. Each King Farm resident 18+ can bring up to 4 guests per amenities pass. Residents 14-17 can bring 1 guest using their pass; and residents 12 – 13 can’t bring any guests.

Please list all members of your household and their ages & relationship to owner/tenant(Required)

i.e. John Doe, SELF, 40; Jane Doe, SPOUSE, 39; Mary Doe, CHILD, 12

First/Last Name

Relationship to Applicant

Age

Applying for a Pass?

Additional Information and Considerations:

Either the owner or the tenant MUST attach a current copy of the lease with the application. Passes will be issued to EITHER THE OWNER OR TENANT, NOT BOTH. No one will be admitted without proper authorization. Amenities passes are $25.00 per pass. All persons using the pool or pool facilities do so at their own risk. King Farm Citizens Assembly assumes no responsibility for any accident or injury in connection with such use, or for any loss or damage to personal property. Your account must have a zero ($0.00) account balance.

Emergency Contact(Required)

Please list your emergency contact and include the following information: First/Last Name, Relationship to you, Phone Number, Email and address (if this person does not reside with you).

PROOF OF RESIDENCY & REQUIRED INFORMATION

Proof of Residency(Required)

Please attach a copy of all applicant’s driver’s licenses as proof of residency. If your address on your license is not a King Farm address, please upload any documentation showing proof of residency (i.e., a recent utility bill or statement, ALTA form, or settlement document).

Drop files here or

Accepted file types: jpeg, png, Max. file size: 1 MB.

Resident Photos:(Required)

Please upload/attach a profile/headshot picture of EACH member of the household applying for a pass (this is used for your resident file and for proof of identity when you use your pass).

Drop files here or

Accepted file types: jpeg, png, pdf, Max. file size: 1 MB.

LEASE (Tenants Only)

Tenant Lease

Please upload a copy of your signed lease.

Drop files here or

Accepted file types: jpeg, png, pdf, Max. file size: 1 MB.

Payment

Using our online payment portal, please pay for each mobile pass ($25 per pass) that you are applying for.

https://www.clover.com/online-ordering/king-farm-citizens-assem-rockville-2

Quantity of Passes

Please indicate the number of passes you are applying for and purchasing.

Please enter a number greater than or equal to 1.

Name

This field is for validation purposes and should be left unchanged.

King Farm Amenities Pass Application Form

Address

ADDITIONAL MEMBERS OF HOUSEHOLD:

Additional Information and Considerations:

PROOF OF RESIDENCY & REQUIRED INFORMATION

LEASE (Tenants Only)

Payment

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