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I wish to join the following home course membership group:
               
 To join Smoke Rise, please click here.
 To join Cateechee, please click here.

 
I wish to join the following membership category:
Tell me more about membership categories
         
 
I choose the following billing option for the MANDATORY annual driving range program:
This program is mandatory for all golf memberships andprovides unlimited range balls at all Canongate locations for you and everyone on your membership. Please indicate how you would like to be billed, either annually or quarterly. A non-response will result in an annual billing cycle.  If you are joining a Social Membership, the Range Program is optional for you. If you would like to participate, please select the appropriate billing option. If you would not like to participate, please choose "No Range". If you are joining a golf membership and select "No Range", you will be billed annually, as the range program is mandatory for all golf members.
Tell me more about the Range Program
   *        
 
I submit the following information for confidential consideration for membership:  All membership categories include the primary member’s spouse and any children who are younger than the age of 25 and living at home. This means that the entire family has access privileges. If a member is unmarried, the membership shall include the individual and any children living at home under the age of 25.
First Name* Social Security#*
Last Name* Birth Date*

Spouse's Name

 Birth Date*
Children

Sex

 Birth Date*
 

Sex

 Birth Date*
 

Sex

 Birth Date*
 

Sex

 Birth Date*
Home Address*    
City*

State*

 Zip*
Home Phone* Cell Phone:
Email Address*    
Billing Address
(if different)		    
City

State

 Zip
Employed by    
Address:
Position: Business Phone:
Please provide a credit card to keep on file:
EZ-Pay Enrollment
All new members have the opportunity to utilize EZ-Pay. This system allows you to automatically pay your dues and charges with your credit/debit card for a $7.00/month administrative fee or with your checking account for no fee. This system is worry-free as you will always receive a detailed statement via mail and email prior to your credit card or checking account being charged. To enroll in EZ-Pay via credit/debit card, simply check the box. If you prefer EZ-Pay via checking account, please ask your Membership Director for a checking account enrollment form. If you are not using EZ-Pay, the club reserves the right to charge your credit card any time your account becomes more than 60 days past due.

I would like to enroll in EZ-Pay and have my monthly account balance charged to the following credit/debit card ($7.00/month charge).
I would like to enroll in EZ-Pay and have my monthly account balance taken directly from my checking account (no monthly charge). Click here to print the appropriate form. Please submit this completed form to the Office Manager along with a voided check.
I do not wish to enroll in EZ-Pay. I will mail or drop off a check to pay my club bill each month.
Type*: Visa / Mastercard AMEX Discover
Credit Card Number*: Expiration Date*  
I would like to charge the entry fee to the above credit card. Amount to Charge*:
One-Year Option: I agree to be responsible for the charges incurred by myself or my family. I agree to abide by all rules and regulations now in effect at the club and any amendments thereto which may be made from time to time. I agree to remain a member for at least one year after which time I can resign by providing the club with a 30 day written notice. I understand that I am responsible for all dues and applicable fees during the 30 day notice period. If I should resign before one year, I agree to pay a $300 cancellation fee. I authorize the above credit card to be charged in the event that my membership balance is over 60 days past due. I further agree to keep this credit card updated as it expires.
Two-Year Option: I agree to be responsible for the charges incurred by myself or my family. I agree to abide by all rules and regulations now in effect at the club and any amendments thereto which may be made from time to time. I agree to remain a member for at least two years after which time I can resign by providing the club with a 30 day written notice. I understand that I am responsible for all dues and applicable fees during the 30 day notice period. If I should resign before one year, I agree to pay a $500 cancellation fee. I authorize the above credit card to be charged in the event that my membership balance is over 60 days past due. I further agree to keep this credit card updated as it expires.
 
I was referred by a member. (If applicable, please fill in Member's information below.)
Referring
Member's Name		 Referring
Member's Number


Upon virtually signing this application, I authorize the disclosure and release of information requested by the Club for investigating my qualifications for membership, including without limitation, my credit history.
   Virtual Signature*:    Date*:  
Note to Business Office:  
Membership profile:
1. What is your proximity to your home club?

   
2. What is your age?

 
3. Who in your household will be utilizing your Club membership? (Check all that apply)
You
Spouse
Children or other dependents
4. What is the approximate value of your home? (All information provided is confidential)

  
5. Do you have friends or family who are members of a Canongate Golf Club?

      If yes, where?
6. Have you previously been a member of any Canongate Golf Club?

            If yes, how long ago did you leave?       
7. How do you plan to use the club? (Check all that apply)
Golf
Swimming (where available)
Tennis (where available)
Social
Dining
Entertaining Business Contacts
8. In what media have you seen or heard Canongate Golf Clubs advertised? (Check all that apply)
Newspaper
Magazine
Radio
Television
Mailing
None
9. Would you or anyone in your family like more information about the following:
Adult Golf Lessons
Junior Golf Lessons
Custom Golf Club Fitting
Getting a USGA Handicap
Canongate Golf League 		Men's Golf Association
Ladies Golf Association
Couples Golf Association
Singles Golf Association
Seniors Golf Association		 Adult Tennis
Junior Tennis
Adult Social Programs
Family Programming
Canongate Junior Tour