Membership Application 202 5 TO AID ADMINISTRATION PLEASE PRINT ALL DETAILS CLEARLY
Date ………………
Name…………………………………………………………………………………………………………………………………………
Address…………………………………………………………………………………... .................................................................
……………….…………………………………………………………………………
Post Code……………………………
Tel: (Home)
……………………………... ............
(Email)………………………………………………………
(Mobile)
……………………………………….
Date of Birth………………………………... .................
Emergency Contact Name/No..........................................................................................................................
Type of Membership (Please tick appropriate category) 7Da y 5Da y
Intermediate Junior Country Golf & Leisure Joint
Start date ………………………….. Finish date …………………………
Payment by: Cheque…….. Credit Card…….. Direct Debit (£35.00 admin charge added) ….…
Please be aware that monthly payments are subject to the full term of the membership agreement, any member cancelling their membership will be liable for payment of the full amount up to their agreed renewal date. However on production of a dated and signed Doctors certificate an alternative agreement can be arranged with the management.
Previous/Other Golf Club(s)…………………………………………………………………………………………………….. .
Would you like Puckrup to be your Home Club? Yes ……….No………
Current CONGU Handicap …………. CDH Lifetime ID No ……………………………….
Please attach current club handicap certificate if available.
A handicap certificate must be supplied by new members along with your Centralised Database of Handicaps ID No . If no certificate is provided 3 cards will need to be completed, marked “For Handicap” under general play and signed by a current club member. Entry to qualifying competitions requires a current valid handicap.
Signed ……………………...... ......................
Print name …………………….... ................
For Official Use Only:
Con
Ex
V1
Lev
EZ
Powered by FlippingBook