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Membership Application ___ Mr. ___ Mrs.
___ Ms. ___ Miss Name: ___________________________________ Home Address: ________________________________________________________________ City: Home
Phone: ______ - _______ - __________ Business Phone: ______ - ______ -__________ Fax: ______ - ______ - __________ Email: ________________________________________ Preferred Method of Communication: ____________________________ Credit Card Information: We require a credit card on file for member signing
privileges. Card:_________________________________
expiry:______________________ Preference of Accrued Account (Please check) Billed Monthly to Card
Invoiced and
Mailed *Please complete the following if more than one active player per
membership Spouse Information ___ Mr. ___ Mrs. ____
Ms. ___ Miss Name:
____________________________________ Business
Phone: ______ - ______ - _____________ Email: _____________________________ Dependant Information Name(s)
Date of
Birth M/F ___________________________
_____________________ _____ ___________________________ _____________________ _____ ___________________________ _____________________ _____
1. We reserve the right to deny membership. 2. Signing privileges will be revoked for accounts not in good
standing 3. For your protection, you must present membership card or number to sign to your account 4. Accounts are invoiced on the
15th of the month and are due on the 30th of the month 5. We have a zero tolerance policy for harassment and abuse at Silver
Brooke Golf Club. Membership will be immediately revoked and no refund issued. It will be up to the
individual case if charges are laid. _____________________________________________ (Date)
___________________ (Applicants Signature) Note: Make cheque payable to Silver Brooke Golf Club Mail To: Silver Brooke Golf Club, Club Use Membership Purchased: Single Member Couple Membership Junior Membership (15yrs and under) Intermediate Membership (16-18 yrs) __ Other
__________________________________________ Membership # assigned
__________________________ Membership Card Issued Payment Details: _______________________________________________________________________________ |
45 Cindy Lane Lisle, Ontario Tel.: 705-434-4100 Fax: 705-434-4110 Email Us |