Lighthouse on the Lake Private Club Membership Application
Choose your tier and provide your details to submit your monthly membership request.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Membership Tier
*
Elite Leader Captain's Table (Professionals, $125/month)
Silver Anchor (Age 65+, $75/month)
Corporate Commodore (Organizations, $300/month)
Elite Leader Captain's Table Couples Membership ($225/month)
Silver Anchor Couples Membership (Age 65+, $125/month)
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Business/Organization Name
Position/Office
Employee Names (up to 3 for Corporate Commodore tier)
Submit Application
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