Membership Application

Membership Application

Application For Membership Privileges
Main Member Information
Name

First NameLast Name
Primary Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Work Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Primary Email
example@example.com
Secondary Email
example@example.com
Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Birthday
Drivers License Number
Occupation and Title
Name of Company
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred Mail Correspondence
Married or Single
Anniversary Date
Shirt Size
Spouse Information
Spouse Member Information
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Spouse Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Birthday
Email
example@example.com
Secondary Email
example@example.com
Occupation / Title
Name of Company
Address If Applicable

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Business Email
example@example.com
Dependent Information

Dependents are considered anyone 23 years and younger. Once the dependent reaches 24 years of age they will be removed from the membership (Depending on availability, memberships may be available for the dependent).

Dependents

Rows	Name of Child	Date of Birth	Male or Female
Child #1
Child #2
Child #3
Child #4
Child #5
Child #6

Personal References

Rows	Name	Phone
Reference #1
Reference #2

Sponsoring Club Member (if applicable)
Classification of Membership and Member Initiation Fee (Dues will be billed off the oldest member on the account).
PAYMENT OF MEMBERSHIP INITIATION (NONREFUNDABLE)The undersigned applicant hereby agrees to pay the required $ membership initiation for a Membership payable within ten days after the date of written notice that this Application for Membership Privileges has been approved.
Are you interested in adding your name to the golf wait list?
Would you like the driving range package to your membership ($650 annually)?
Please upload an individual or family picture we can upload into your app. You can change this later if needed! Thank you

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MEMBERSHIP PRIVILEGES IN THE CLUB
I hereby acknowledge that the Club Facilities are owned and operated by Eagle Run West Golf Partnership do- ing business as Champions Run (the “Club”) and that membership in the Club permits the member to use the Club Facilities, but it is not an investment in the Club, nor does it confer on the member any equity or ownership interest or any other property interest in the Club or the Club Facilities. Membership does not give a member a vested or prescriptive right or easement to use the Club Facilities, but grants to the member a revocable license to use the Club Facilities. Members will not have any interest in the income of the Club and do not have any right to receive any of the Club’s assets if the Club is dissolved.

CANCELLATION OF CLUB MEMBERSHIP
A resigned member shall be obligated to continue to pay dues, fees and other charges associated with the resigned membership until the end of the calendar year. A resigned member shall be permitted to use the Club Facilities as long as dues continue to be paid.

MEDIA RELEASE NOTICE
This contract gives Champions Run permission to include member photos and videos on printed materials, newsletters, Club website and social media pages for promotion purposes.

Upon signing this Application for Membership Privileges, I authorize the disclosure and release of information to Champions Run for investigating my qualifications for membership and authorize those persons or entities herein to furnish information to Champions Run.

I understand that acceptance for membership in Champions Run is subject to approval by Champions Run and payment of the required membership deposit, dues and other charges as may be charged from time to time.

If the Applicants are married, the signatures of both spouses are required.
Applicant Signature
Spouse's Signature (if applicable)
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
CHAMPIONS RUN

13800 Eagle Run Drive Omaha, Nebraska 68164 (402) 498-8900

This Application for Membership Privileges shall be governed by and construed in accordance with the laws of the State of Nebraska without regard to principles of conflicts of laws.
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Membership Application

Spouse Information

Dependent Information