St. Vrain Lakes Metropolitan District No. 1 Additional Authorized User Form All adult Additional Authorized Users must complete this form AND be listed on a Property Owner Form AND sign a Waiver and Consent Form in order to access the Recreation Amenities. USER INFORMATION: Last Name First Name Home Phone Cell Phone Residence Address City State —Please choose an option—AKALAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Relationship to Owner (Examples: Tenant/Renter, Nanny, Grandparent/Grandchildren) Email for contact purposes 2nd Person Last Name 2nd Person First Name Home Phone Cell Phone Relationship to Owner (Examples: Tenant/Renter, Nanny, Grandparent/Grandchildren) Email for contact purposes Emergency Contanct (Not Immediate Family) Emergency Contact Telphone NOTE: Minors must be accompanied by a Property Owner or another Additional Authorized User unless a Minor Release Form is on file with the District Manager. MANDATORY INFORMATION ON PROPERTY OWNER AUTHORIZING USE: Address of Property Owner Authorizing Use: (In-District Address) City State —Please choose an option—AKALAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Owner Last Name Owner First Name Home Phone Cell Phone EACH ADDITIONAL USER MUST ALSO SIGN A WAIVER AND CONSENT FORM