Avalon Lakes Golf Course Online Membership Application

Avalon Golf and Country Club

Non-Resident Membership Application

I hereby apply for admission as a member of the Avalon Golf and Country Club. If accepted I agree to abide by the terms and conditions of membership now in effect or as adopted or amended.

Applicant's Name:

Date of Birth:

Home Address:

City:

State:

Zip:

Home Phone:	Home Fax:	Cell Phone:
E-mail:
Applicant's Title/Occupation
Business Name:
Business Address:
City:	State:	Zip:
Bus. Phone:	Bus. Fax:
E-mail:

Is this business responsible for payment of dues?

Yes No

Should Club correspondence be sent to the business address or home address

Do you or your spouse reside either on a full or part-time basis, or are either of you employed in any of the following counties: Mercer, Lawrence, Trumbull, Mahoning or Columbiana? YesNo

PLEASE COMPLETE THE FOLLOWING IF YOUR SPOUSE IS ALSO JOINING

OR IF YOU ARE PURCHASING A FAMILY PLAN

Spouse's Name:

Date of Birth:

Children's Names: (If applicable, please list university and graduation date.)
Name	Date of Birth	University/Graduation Date

PLEASE COMPLETE THE FOLLOWING IF A PERSONAL HOUSE ACCOUNT
(CHARGING PRIVILEGES) IS REQUESTED
Member's Social Security Number:
Member's Primary Bank:		Account Number:
Address:
City/State/Zip
The following family members are also allowed to charge on my account (Family memberships only).


I hereby request Avalon Golf and Country Club (the "Club") to grant me
credit in accordance with the terms and conditions of membership. I certify that all the above
information herein is true and complete. I authorize the Club to retain this application, to rely
on the foregoing, to check and verify my credit history by obtaining credit reports from consumer
reporting agencies, and to obtain such other information concerning my credit worthiness as the
Club deems necessary. I further authorize my references and financial institutions to release or
verify information to the Club.

Member:		Date:
Signature

PLEASE COMPLETE THE FOLLOWING IF A BUSINESS OR CORPORATE HOUSE ACCOUNT IS REQUESTED
Type of Business: Corporation Sole-Propietor Partnership
Business' Primary Bank		Account Number:
Address:
City/State/Zip
Account Officer		Telephone Number:
TRADE REFERENCES
1) Name		2) Name
Address		Address

Phone		Phone
The undersigned hereby requests Avalon Golf and Country Club to grant the above business credit in accordance with the terms and conditions of membership.

Application completed by:
Printed Name		Title
Signature

The Ohio laws against discrimination require that all creditors make credit equally available to all credit worthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio civil rights commission administers compliance with this law.

In consideration of acceptance is a member of Avalon Golf and Country Club, ("Club") I agree to the following:

1. I acknowledge receipt of and agree to familiarize myself with and abide by the terms and conditions of membership of the Club as now in effect or as amended in the future. 2. I understand that I am personally responsible for dues and all other charges and that all amounts due will be paid within 30 days or within other limits fixed by the Club. I understand that delinquent accounts will be charged late fees and interest and that my membership may be suspended or terminated for non-payment. 3. I agree that any resignation submitted by me shall be in writing to the Club. I understand that my resignation shall not relieve me of any obligations or indebtness of mine to the Club and that I remain responsible for all charges. 4. I understand that dues are annual and my election to pay dues on a monthly basis does not relieve me of my obligation to pay the annual dues in full. 5. I understand and agree that if I use the Club exercise facilities and equipment it will be at my own risk. I hereby knowingly and voluntarily waive any claim that I may have against the Club or its affiliates arising from such use. 6. I hereby acknowledge that all of the statements set forth in this application are true and correct, and that I have withheld no information of a material nature, which would affect action on my membership application.


Signature of Applicant	Date