Membership Application

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1 Membership Application 2287 Club House Rd Glen Rock, Pennsylvania

2 Type of Membership Desired Check One: Full Golf Memberships o Full Family o Young Family o College o Full Single o Young Adult o Full Junior o Golden Age Couple o Non-Resident o Corporate o Golden Age Single o Associate Swim/Social Memberships o Family Swim/Social o Single Swim/Social o Junior Swim Full Membership - Golf Bon Air Country Club s full memberships including golf are broken down into the following categories. FULL FAMILY: A Full Family membership entitles all members of the immediate family (husband, wife and dependent children) to full golf, swim and social privileges in accordance with BACC rules and regulations. Dependent children eighteen years old and older are not eligible unless they are a full time student in which case they shall remain eligible until December 31st in the year they reach the age of twenty-three. In order to be considered full time, a student cannot miss more than one semester of school. Dues $ Monthly With 25% Discount $ Monthly FULL SINGLE: A Full Single membership entitles the individual named on the application to full golf, swim and social privileges in accordance with BACC rules and regulations. A Full Single member must be at least eighteen (18) years of age. Dues $ Monthly With 25% Discount $ Monthly GOLDEN AGE COUPLE: A Golden Age Couple membership entitles the husband and wife named on the application to full golf, swim and social privileges in accordance with BACC rules and regulations. Both individuals must be retired and at least sixty-five (65) years of age by 1 Jan of the year that the Golden Age Couple membership takes effect and have held a family golf membership for at least ten (10) consecutive years. Dues $ Monthly With 25% Discount $ Monthly GOLDEN AGE SINGLE: A Golden Age Single membership entitles the individual named on the application to full golf, swim and social privileges in accordance with BACC rules and regulations. The individual must be retired and at least sixty-five (65) years of age by 1 Jan of the year that the Golden Age Single membership takes effect and have held a golf membership for at least ten (10) consecutive years. Dues $ Monthly With 25% Discount $ Monthly YOUNG FAMILY: A Young Family membership entitles all members of the immediate family (husband, wife and dependent children) to full golf, swim and social privileges in accordance with BACC rules and regulations. A Young Family Member must be at least thirty-one (31) and not more than thirty (35) years of age by December 31of the last year of eligibility. Dues $ Monthly With 25% Discount $ Monthly YOUNG ADULT: A Young Adult membership is available to families and individuals age 30 and under. Membership entitles individual and all members of the immediate family (husband, wife and dependent children) to full golf, swim and social privileges in accordance with BACC rules and regulations. A Young Adult Member must be at least Eighteen years of age (18) and not more than thirty (30) years of age by December 31of the last year of eligibility. Dues $ Monthly With 25% Discount $95.31 Monthly

3 NON-RESIDENT: A Non-Resident membership (primary residence outside 100 mile radius of Bon Air) entitles individual and all members of the immediate family (husband, wife and dependent children) to full golf, swim and social privileges in accordance with BACC rules and regulations. Non-Resident members are entitled to participate in all tournaments, events and activities at the club. Non-resident members pay prevailing guest fees for golf and pool access. This is a non-voting membership category. Dues $ Yearly With 25% Discount $ Yearly ASSOCIATE: An Associate membership entitles the individual named on the application to the same privileges as a Full Single membership. The individual must be the son or daughter of an individual currently holding a Full Family membership. Member must be at least eighteen (18) and not more than twenty-five (25) years of age by December 31 of the last year of eligibility. Dues $ Monthly With 25% Discount $76.26 Monthly COLLEGE: A College membership entitles the individual named on the application to golf, swim and social privileges in accordance with BACC rules and regulations. A College Member must be eighteen years old or older and is not eligible unless they are a full time student in which case they shall remain eligible until December 31st in the year they reach the age of twenty-three. In order to be considered full time, a student cannot miss more than one semester of school. Course availability is limited as described in club rules. Dues $ Annually With 25% Discount $ Annually FULL JUNIOR: A Full Junior membership entitles the individual named on the application to golf, swim and social privileges in accordance with BACC rules and regulations. Member must be at least fourteen (14) by December 31 of the year that the membership starts and no more than eighteen (18) years of age by 31 December of the year the member graduates from high school. Course availability is limited as described in club rules. Dues $ Annually With 25% Discount $ Annually MEMBER EMERITUS: In honor of their long and faithful membership in BACC those members who have reached the age of eighty (80) years and have been a member of BACC for at least twenty (20) uninterrupted years will be granted Member Emeritus status. A Member Emeritus is entitled to full golf, swim and social privileges in accordance with BACC rules and regulations with the sole exception that they are no longer required to pay membership dues. CORPORATE: A Corporate membership entitles one individual designated (Primary) by the company to the same privileges as a Full Family membership. In addition, three (3) additional employees of the company (Alternates) are entitled to golfing privileges with payment of greens fees established by the BACC Board of Directors. It is the company s responsibility to provide the names of the Primary and Alternates in writing to the BACC Board of Directors for approval. When primary terminates, Corporate Membership expires. Dues $ Monthly With 25% Discount $ Monthly Swim Membership/Social Bon Air Country Club s swim memberships including social are broken down into the following categories. FAMILY SWIM/SOCIAL: A Family Swim/Social membership entitles all members of the immediate family (as defined Full Family Golf Membership) to full swim and social privileges in accordance with BACC rules and regulations. Membership includes one round of golf per month with up to 3 guests. (Guest fees apply) Dues $ Yearly With 25% Discount $ Yearly SINGLE SWIM/SOCIAL: A Single Swim/Social membership entitles the individual named on the application to full swim and social privileges in accordance with BACC rules and regulations. A Full Single member must be at least eighteen (18) years of age. Membership includes one round of golf per month with up to 3 guests. (Guest fees apply) Dues $ Yearly With 25% Discount $ Yearly JUNIOR SWIM: A Junior Swim membership entitles the individual named on the application to swim privileges in accordance with BACC rules and regulations. Member must be at least fourteen (14) by 31 December of the year that the membership starts and no more than eighteen (18) years of age by 31 December of the year the member graduates from high school. Dues $ Yearly With 25% Discount $ Yearly

4 Personal Information Name Primary Address Alternate Address Length of Time at Primary Address Home Telephone Number Date of Birth Spouse s Name Spouse s Date of Birth Spouse s Home Telephone Number Social Security Number Cell Phone Number Address Spouse s Address Spouse s Social Security Number Spouse s Cell Phone Number o Single o Married o Divorced o Widowed Wedding Anniversary Date Please list your dependent children under the age of twenty-five. Name Date of Birth Male Female o o o o o o Business Information Applicant s Occupation and/or Nature of Business or Profession o Retired Name of Company Title Business Address Business Telephone Number Business Fax Number Years in Present Employment Address Spouse s Occupation and/or Nature of Business or Profession o Retired Name of Company Title Business Address Business Telephone Number Business Fax Number Years in Present Employment Address

5 Statement & Newsletter Preference ed Newsletters o Home o Business ed Statements o Home o Business I prefer to receive my general mail at: o Home o Business Do you play golf? How long have you played golf? USGA Handicap Does your spouse play golf? How long has your spouse played golf? USGA Handicap Reference Information Please list membership in other Clubs, fraternities or organizations and positions held I am acquainted with the following Bon Air Country Club Members: Sponsor for years. Name for years. Name for years. Credit References Banks (1) Name (2) Name Address Address City State Zip Code City State Zip Code Personal (1) Name (2) Name Address Address City State Zip Code City State Zip Code Credit Card Information Type Card Number Expiration Date Security Code Name on Card Telephone Number Associated with Card Billing Address for Card

6 Authorization and Agreement The undersigned hereby confirms that the information provided in this application is true, complete and correct, and hereby authorizes The Bon Air Country Club (the Club ), through its representatives, to conduct such inquiry into the undersigned s financial condition and professional background as it deems necessary and appropriate. The undersigned acknowledges and agrees that (i) this application for membership is submitted in connection with the 2018 Membership Drive of the Club, (ii) there is an application fee (equal to 4 months dues at the current rate) which will act as a deposit on your membership dues. Deposits on memberships billed annually will be $ Deposits are due upon submission of this application, and (iii) by submitting this application, the undersigned is making a commitment to remain a member of the Club for a period of 2 years from the Acceptance Date on this Application (the Commitment Period ). Failure to stay for the full two year term disqualifies the member from eligibility for the discount and any discount received must be repaid. Exceptions will be made for those relocating more than 75 miles from the club. If this application is accepted, and the applicant is admitted in accordance with the formal admission procedures of the Club, the undersigned agrees to observe and be bound by the Bylaws and Rules and Regulations of the Club in effect which may be updated from time to time. The undersigned agrees to maintain a current valid credit card on file with the Club at all times, and hereby authorizes the Club to charge such credit card for any amounts owed to the Club, including amounts reflected on monthly invoices, that are more than Thirty (30) days past due. The undersigned hereby acknowledges and agrees that he/she is personally liable and responsible for all financial obligations relating to his/her membership, including any obligations relating to the use of the Club by his/her family members and guests. Signature of Applicant Date OFFICE USE ONLY ACCEPTED THIS DAY OF 20. MEMBERSHIP CHAIRPERSON. PRESIDENT Club House Rd Glen Rock, Pennsylvania

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