Membership Application. UPDATED

MEMBERSHIP CATEGORY*

Applicant's Name*

First NameLast Name

I [Applicant's Name], hereby make application to Tuscawilla Country Club ("Club"), to become a Member of the Club, in the category specified above. If accepted, I agree to abide and be bound by the Terms and Conditions of Application and all of the Club's Rules and Regulations, as each now exist or may hereafter be amended by the Club.

I understand that until my Application is approved and activated, I cannot use the Club or its facilities. Acceptance of Application for Membership is in the sole discretion of the Club and if my Application is refused for any reason,I understand that my Application Fee will be returned to me.

I HEREBY ACKNOWLEDGE THAT I AM ACQUIRING A MEMBERSHIP FOR THE SOLE PURPOSE OF OBTAINING RECREATIONAL USE OF THE CLUB FACILITIES, AND NOT AS AN INVESTMENT OR FOR AN ECONOMIC PROFIT AND THAT NO PERSON EMPLOYED BY THE CLUB OR PURPORTING TO SPEAK FOR THE CLUB HAS MADE ANY PROMISE OR HELD OUT ANY INDUCEMENT TO ME CONTRARY TO THE INFORMATION IN THE MEMBERSHIP BROCHURE OR RULES AND REGULATIONS.

APPLICANT'S FULL NAME*

BIRTH DATE*

Date

DRIVERS LICENSE NUMBER AND STATE*

SPOUSE'S FULL NAME*

please enter n/a if not applicable

BIRTH DATE*

Date

SPOUSE'S DRIVERS LICENSE NUMBER AND STATE*

please enter n/a if not applicable

WEDDING ANNIVERSARY DATE

Date

RESIDENTIAL ADDRESS*

CITY*

STATE*

ZIP CODE*

HOUSING COMMUNITY*

please enter n/a if not applicable

HOME TELEPHONE

CELL PHONE NUMBER*

APPLICANTS EMAIL*

example@example.com

SPOUSES EMAIL

example@example.com

Mailing Address (if different from above)

CITY

STATE

ZIP CODE

LIST ALL CHILDREN OF APPLICANT AND SPOUSE AGE 22 AND UNDER. Unmarried children age 12 through 22 who reside at home, attend school on a full-time basis or are on active military duty are eligible to be issued Membership privileges entitling them to charge privileges. Please indicate which children should receive charging privileges.

CHARGE PRIVILEGE/ISSUE CARD YESNO

1. Child's Name

First NameLast Name

1. Child's Birth Date

Date

1. Child Has Charging Privilege/Issue Card

YesNo

2. Child's Name

First NameLast Name

2. Child's Birth Date

Date

2. Child Has Charging Privilege/Issue Card

YesNo

3. Child's Name

First NameLast Name

3. Child's Birth Date

Date

3. Child Has Charging Privilege/Issue Card

Type option 1Type option 2

4. Child's Name

First NameLast Name

4. Child's Birth Date

Date

4. Child Has Charging Privilege/Issue Card

YesNo

APPLICANTS OCCUPATION*

TITLE*

EMPLOYED BY*

YEARS EMPLOYED*

EMPLOYERS ADDRESS*

TELEPHONE*

PREVIOUS EMPLOYERS*

SPOUSES OCCUPATION

TITLE

SPOUSES EMPLOYER

EMPLOYER'S ADDRESS

YEARS EMPLOYED

TELEPHONE

PREVIOUS EMPLOYERS

I HEREBY ACKNOWLEDGE THAT ALL PAYMENTS TO TUSCAWILLA COUNTRY CLUB ARE PAYABLE AND DUE BY THE FIFTEENTH (15TH) OF EACH MONTH. I UNDERSTAND THAT TUSCAWILLA COUNTRY CLUB DOES NOT EXTEND CREDIT TO ANY MEMBER, AND THAT LATE FEES WILL BE CHARGED ON ANY UNPAID BALANCE AFTER THE FIFTEENTH (15TH) OF EACH MONTH.

I HEREBY ACKNOWLEDGE THAT ALL DUES, FEES, AND CHARGES NOT PAID WHEN DUE CAN BE BILLED TO MY CREDIT OR DEBIT CARD LISTED ON FILE AND I HEREBY AUTHORIZE SUCH BILLING. I UNDERSTAND THAT I MAY BE CHARGED A LATE PAYMENT CHARGE OF TWELVE PERCENT PER MONTH. I FURTHER UNDERSTAND THAT IF PAYMENT IS NOT MADE AND I DO NOT HAVE A VALID CREDIT CARD ON FILE THAT I MAY BE SUSPENDED UNTIL ALL MONIES DUE ARE COLLECTED AND RECEIVED BY TUSCAWILLA COUNTRY CLUB. I ALSO UNDERSTAND THAT IF I AM SUSPENDED TWICE WITHIN ONE YEAR THAT MY MEMBERSHIP MAY BE AT RISK.

I certify that the credit card listed as my current credit card on file, is issued to me and agree that all disputes on my credit card or debit card account relating to Tuscawilla Country Club will be promptly brought to the attention of Tuscawilla.I understand that I am obligated to keep a valid approved credit card or debit card on file with Tuscawilla Country Club at all times. The card information listed on file is NOT an automatic auto-enrollment in Tuscawilla's Auto Pay Program and the card information listed on file is kept in the event of a past due balance. A card listed on file will only be used in Tuscawilla's Auto Pay Program if specified. I understand that I will receive a monthly statement from Tuscawilla Country Club, that it is my responsibility to review my statement and bring to the attention of the Tuscawilla accounting department any and all billing disputes on a monthly basis. I further understand that all disputes must be brought to the attention of the Tuscawilla accounting department within a 60 day period of receiving my monthly statement or I may lose the right to dispute the charges in question and receive a full credit due. Resignation is permitted only in accordance with the terms listed under Terms and Conditions of Application and Rules and Regulations. Membership and MUST be in writing before Tuscawilla Country Club acknowledges the request for resignation.

1. EMERGENCY CONTACT NAME*

First NameLast Name

1. PHONE NUMBER*

Please enter a valid phone number.

1. RELATIONSHIP*

2. EMERGENCY CONTACT NAME

First NameLast Name

2. PHONE NUMBER

Please enter a valid phone number.

2. RELATIONSHIP

3. EMERGENCY CONTACT NAME

First NameLast Name

3. PHONE NUMBER

Please enter a valid phone number.

3. RELATIONSHIP

1. NAME OF CLUB

1. ADDRESS

1. CURRENT OR FORMER MEMBER

2. NAME OF CLUB

2. ADDRESS

2. CURRENT OR FORMER MEMBER

3. NAME OF CLUB

3. ADDRESS

CURRENT OR FORMER MEMBER

Terms and Conditions of Application and Membership A.This Application shall entitle the Applicant to apply for Club Membership privileges provided by the Club after Applicant is approved and accepted by the Club. This Application will not be acted upon unless fully completed, executed and accompanied by a check or credit card for payment of the Membership Fee.

B.Applicant acknowledges receipt of and agrees, by execution of this Membership Application, upon acceptance of application by the Club, to be bound by the Rules and Regulations, as they each may be amended from time to time. Membership is subject to suspension or termination for failure to abide by Membership conditions. Applicant further acknowledges and agrees to be responsible for all dues and charges incurred that shall be due and payable no later than 30 days from the date of the monthly statement. Applicant's signature below authorizes the Club to charge the credit card listed on file for their account for all charges that exceed thirty (30) days. All costs and expenses incurred by the Club in the collection of any amounts not paid when due, including, but not limited to court costs, collection fees and attorney's fees, whether at the trial level or on appeal, shall be charged to Applicant, and shall be due and payable upon demand.

C.Applicant acknowledges that the Membership is not an investment in the Club, nor does it provide an equity or ownership interest in the Clubor Club Facilities. Membership in the Club does not confer upon the Applicant a vested right or prescriptive right or easement to use the Club Facilities. Applicant acknowledges that a Member only acquires a revocable license to use the Club Facilities in accordance with the Rules and Regulations and the privileges associated with the Membership category and dues option acquired. The Club reserves the right, at any time or from time to time, in its sole and absolute discretion, to reserve Memberships, to discontinue operation of any or all of the Club Facilities, to sell or otherwise dispose of the Club Facilities in any manner whatsoever and to any person whomsoever, to terminate any or all types of Membership and to make any other changes in the terms and conditions of Membership or facilities available for use by Members.

D.Applicant covenants and agrees to indemnify and hold harmless the Club and its Members, partners, shareholders, directors, officers, employees, representatives, affiliates and agents in accordance with the provisions of the Rules and Regulations of the Club.

E.Applicant acknowledges that use of the Club Facilities may be restricted from time to time, and that use, service or other charges may vary from time to time.

F.Upon signing this Application, Applicant authorizes the disclosure and release of information to the Club for investigating Applicant's qualifications for Membership, and authorizes all persons or entities mentioned above to furnish information to the Club, including, without limitation, Applicant's credit history. Applicant agrees that all information and communications received by the Club in connection with this Application are privileged, confidential and not subject to disclosure to Applicant or to any other person other than authorized Club personnel. Applicant agrees never to make demand on the Club or any other person to disclose any of the information or communications to Applicant, and Applicant releases the Club, and its Members, partners, officers, directors, shareholders, employees, representatives, affiliates and agents and any person providing information or communications from any liability in connection therewith.

G.Resignation is permitted only in accordance with the Rules & Regulations that includes giving the Club a written notice of intent to resign at least six (6) months in advance. Applicant acknowledges that if they wish for immediate termination, they are required to pay six (6) months of the current posted membership dues in the existing membership category listed on their account, plus any remaining unspent food minimum balance.

If any clause, provision or section of this Application is determined to be illegal, invalid or unenforceable by any court, the illegality, invalidity or unenforceability of such clause, provision or section shall not affect any of the remaining clauses, provisions or sections and the Application shall be constructed and enforced as if such illegal, invalid or unenforceable clause, provision or section had not been included.

APPLICANTS SIGNATURE*

DATE*

Date

SPOUSES SIGNATURE

DATE

Date

BUSINESS

IN CASE OF EMERGENCY

SOCIAL REFERENCES