2023 Pool Only Application Form

Contact Information

First Name

Last Name

Mailing Address

Mailing Address City

Mailing Address State

Mailing Address Zip Code

How should we contact you ?

Home Phone

Cell Phone

Kiawah Island Phone

Email Address

Information Requested

Billing Email Address

Birthday (month/day)

Primary Photo
(png, jpg, jpeg, gif only)

Spouse First Name

Spouse Last Name

Spouse Email Address

Spouse Birthday (month/day)

Spouse Cell Phone

Spouse Photo (headshot or photo from phone)
(png, jpg, jpeg, gif only)

Child 1 Name (under 25)

Child 1 Birthday (month/day/year)

Child 1 Photo (headshot or photo from phone)
(png, jpg, jpeg, gif only)

Child 2 Name

Child 2 Birthday (month/day/year)

Child 2 Photo (headshot or photo from phone)
(png, jpg, jpeg, gif only)

Additional Children Names/Birthdays (month/day/year) (under 25)

Child 3 Photo (headshot or photo from phone)
(pdf only)

Child 4 Photo (headshot or photo from phone)
(png, jpg, jpeg, gif only)

Kiawah Island /Local Address

Membership Category

Pool Add-On Option ($220) for Adult children, grandchildren, parents and siblings

A valid credit card number is required to process the membership application. $1023.75 including 5% tax will be charged to the credit card. Credit cards numbers can be taken in person or over the phone, they are not accepted online or via email. By submitting this form you agree to the Terms and Conditions of the Governor's Club. Membership is automatically renewed annually.

* Bold Fields are Required

Welcome back, members.

2023 Pool Only Application Form

Contact Information

How should we contact you ?

Information Requested