membership-application

Please complete the form below then click the "Print this page" button at the bottom. Sign and date your form, then send to: Northern Dunes Golf Club 665 Bruce Street, Hepworth, ON, NOH 1PO or fax (519) 935-3157.

PERSONAL INFORMATION
New Member    Existing Member     Member Number:
Name(s):
Salutation: First: Middle: Last:
Salutation: First: Middle: Last:
Address:
City: Prov: Postal Code:
Home Phone: Work Phone:
Email: Date of Birth:


TYPE OF MEMBERSHIP
  Anytime Weekday Only
Couple Membership $1,739.95 $1,539.95
Adult Membership $  944.95 $  794.95
Senior Membership $ 894.95 $  744.95
Student Membership $  579.95 $  479.95
Junior Membership $ 399.95 $  319.95
Family Membership $2,099.95 $2,099.95
Power Cart Membership (Single) $599.95 $899.95


10TH ANNIVERSARY DISCOUNTS (Must Renew or join by April 30, 2010)

Anytime Weekday Only
Couple Membership $87.00 $77.00
Adult Membership $47.25 $39.75
Senior Membership $44.75 $37.25
Student Membership $29.00 $24.00
Junior Membership $20.00 $16.00
Family Membership $105.00 $105.00
Power Cart Membership $50.00

 

CALCULATING COST
YES, I wish to use my ADVANTAGE PLUS POINTS
Advantage Plus Points:
Dollar Value: $
GST No: 88262-3150 RT001
Cost of Membership: $
Early Renewal Discount: $
Sub-Total: $
PST: $
GST: $
Total: $
Less: Advantage Plus: $
Total Owing: $


PAYMENT METHOD
Cash (Only accepted as a full payment)
Cheque (Made payable to Northern Dunes Golf Club Ltd.)
Credit Card - - -    Expiry: /


PAYMENT PLAN
Full Payment $ Due on signing


I/We acknowledge that Northern Dunes Golf Club Limited, for purposes reasonably associated with its operations as a golf and restaurant facility, may from time to time disclose and distribute to its members, golf organizations, and other members of the public, the information provided herein, and I/We hereby consent to such uses of this information.

Upon payment of the fees referred to in this application, the party or parties are entitled to the use of the facilities for which prescribed payment has been accepted by Northern Dunes Golf Club Limited. The facilities may be used in accordance with the rules and regulations as determined from time to time by Northern Dunes Golf Club Limited. Northern Dunes Golf Club Limited may revoke or suspend the privileges granted for breach of rules and regulations. Upon payment being made and accepted, there shall be no refund or rebate save as set forth by Northern Dunes Golf Club Limited. Note: No voting privileges are acquired upon payment of the fees for the use of the facilities.                

Complete the following only after the form is printed.

Member Signature: Date:




E-mail link
Northern Dunes Golf Club 665 Bruce Street  •  Hepworth, ON  •  NOH 1P0
T: (519) 935-3000  •  F: (519) 935-3157
E: golf@northerndunes.com
Website service provided by Golfmax Inc.