Student Membership (over 18)

Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Student’s Date of Birth

MM

DD

YYYY

Acceptance of terms *

By checking this form you are assuming responsibility for all charges, costs and other miscellaneous fees as a result of the student membership including club charges, cart, and course damage. Cost of Membership Student membership 215.00 Tax 15.05 Total $230.05 All student applications are subject to Board approval and payment in full is required with this form.

I accept these conditions