Valleyfield Homeowners Association, Inc.
Member Pool Card Key Receipt Form
serves as a receipt for each memberís new pool card key. Each homeowner is
entitled to one key, programmed based on their homeís address in the community.
Loss or damage of this card will require member to purchase a new card for a
fee of $5.00. Please report all lost or stolen cards to the VHOA Board of
Directors as soon as possible to ensure card is not used by unauthorized
personnel. Signing this form, members agree to continue to abide by all VHOA
documents including the Declaration of Covenants, Conditions, Restrictions, and
Easements, and the associated Community Bylaws. Non-compliance with these
documents or failure to pay your quarterly dues can result in loss of access to
the pool and other community activities as stated in Article 6.4 of the
Declaration. [Article 6.4: If the violation is the nonpayment of any general or
special assessment, the Association shall have the right to suspend the offending
Ownerís voting rights and the use by such Owner, his agents, employees and
invitees of the Common Areas in the Subdivision for any period during which an
assessment against the
Memberís Name (Print):__________________________________________
Memberís Street Address:_________________________________________
Lost Key _____†† $5.00††††††††††††††††††††††††† New Key ______
If you are in compliance with the VHOA documents and current on your homeownerís dues, please fill out and sign this form. Forms should be dropped off in the mailbox on the pool's main gate unless this is a lost key application. We will then be distributing the pool card keys to each homeowner as soon as we can after we are in receipt of your form.† Please allow 5-7 business days for your key. Please make every effort to return this form as soon as possible. Thank you for your support.
$5.00 payment for lost key to
1140 Holly Springs Rd.
Holly Springs, NC 27540
Phone: (919) 521-5394