Membership Application

Thank you for your interest in joining Mount Vernon Park.

To join our membership waiting list, please complete this form, and submit a non-refundable $50 application fee via credit card. Due to the current length of the waiting list, we estimate that you would be offered a membership for the season 1-2 years from your application. That is only an estimate, and is subject to change.

When approved for membership, you will have to pay a one-time, non-refundable Initiation Fee of $1,000 and annual dues of a base fee of $638 plus $89.25 per family member/$89.25 per caregiver (2025 season), which varies according to the size of your family.

You should receive an email confirming receipt of your application after filling out the application and paying the fee. If you have any questions or don’t receive the confirmation email, please contact Jim Phalen, our Membership Chair, at mt.vernon.park.membership@gmail.com.

"*" indicates required fields

Billing Contact Name*

First Last

Enter the name of the person who should be contacted if membership becomes available or with any questions regarding the wait list application. You should receive an email confirming receipt of your application after paying. Contact mt.vernon.park.membership@gmail.com if you don't.

Address*

Street Address City State ZIP Code

Cell Phone*

If you don't have a cell phone, please enter your landline number.

Email*

Username - create a username with no symbols*

Secondary Email

Password*

Enter Password Confirm Password

Strength indicator

Select a password that you will use to access your wait list account. You will be able to send a password reset link to the email address you entered above if necessary.

Are You a Returning Member*

Yes

Are Your Parents Members*

Yes

Number of People in Household*

Wait List Fee*

Price:

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

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