2021 PARKS AND RECREATION EMPLOYEE BENEFIT STATEMENT

Seasonal Employee

To participate in this program, please gain permission from your supervisor first with a signature below and then

contact Parks and Recreation located at 1340 Gunnison Avenue or call 254-3866.

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2021 BENEFIT INFORMATION

•  Seasonal employees need to work an average of 10 hours per week for the calendar year to qualify for this benefit.

•  One access card per employee will be issued for Aquatics passes. Replacement cards or additional cards are $10 per card.

•  Employee discounts will not be granted “at the door” of the facility without first obtaining the access card from Parks and Recreation Administration Office.

•  2020 benefits are available for use beginning January 1, 2021 through December 31, 2021.

•  Full Time and Seasonal Employee Golf and Swim Benefits are classified as taxable fringe benefits according to the Internal Revenue Service (Publication 15-B). The City is required to tax the value of these discounts/benefits (the value of the pass minus the amount you paid) and report them as taxable income on the benefiting employee's W-2. For 2021, you will be taxed for the value of the discount in the pay period following the purchase of the Golf or Swim pass.

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GOLF Birdie Pass - $35 Per Employee

•  Employees will be able to play golf rounds at Tiara Rado and Lincoln Park for a discounted rate on green fees. Check the course rate sheet for more information.

•  The golf benefit is for employee use ONLY and the access card must be shown for each tee time.

•  Immediate family members will not receive the golf benefit.

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AQUATICS - $25 Per Employee or Immediate Family Members living in the same household

•  Eligible to receive an annual aquatics pass which costs $25 per person.

•  Annual passes are available for the Lincoln Park-Moyer Pool and Orchard Mesa Pool.

•  Aqua aerobics classes are included in the annual pass.

•  Learn to Swim classes, waterslide, hot tub, etc. are not discounted and an access card does not account for these additional fees.

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Supervisor Signature: ___________________________ Supervisor Printed Name: _____________________________

Supervisors Contact Phone Number: _________________

By signing this, supervisor is verifying that employee is working an average of 10 hours per week for the calendar year.

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Please Print                        

Name:

Department:

Birth Date:

Email:

Mailing Address:

City:

Zip:

Home Phone:

Work Phone:

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Golf Pass ($400) Aquatics Adult Summer Pass ($107) Aquatics Senior Summer Pass ($79)

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Aquatics Adult Annual Pass ($293) Aquatics Senior Annual Pass ($216)

  

Family members who wish to have a swim pass:

 

Family Member #1:

Birth Date:

Relationship:

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Aquatics Senior Summer Pass ($79) Aquatics Adult Summer Pass ($107) Aquatics Youth Summer Pass ($79)

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Aquatics Senior Annual Pass ($216) Aquatics Adult Annual Pass ($293) Aquatics Youth Annual Pass ($216)

Family Member #2:

Birth Date:

Relationship:

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Aquatics Senior Summer Pass ($79) Aquatics Adult Summer Pass ($107) Aquatics Youth Summer Pass ($79)

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Aquatics Senior Annual Pass ($216) Aquatics Adult Annual Pass ($293) Aquatics Youth Annual Pass ($216)

Family Member #3:

Birth Date:

Relationship:

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Aquatics Senior Summer Pass ($79) Aquatics Adult Summer Pass ($107) Aquatics Youth Summer Pass ($79)

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Aquatics Senior Annual Pass ($216) Aquatics Adult Annual Pass ($293) Aquatics Youth Annual Pass ($216)

 

All fees are due at time of registration. All passes are nonrefundable.

Signature:

Date: