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 year 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 $950 and annual dues of a base fee of $573 plus $80 per family member/$80 per caregiver (2023 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.

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
- No
Are Your Parents Members*
- Yes
- No
Number of People in Household*
View MVPA Rules and Regulations here

View MVPA By-Laws here
Terms of Membership*
I understand that my application will be placed on a waiting list and is subject to approval by the Mount Vernon Park Association Board of Directors. If I am accepted for membership, I will abide by all of the Rules, Regulations and By-Laws of Mount Vernon Park.
I agree to the terms of membership
Wait List Fee*
Price:
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
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