Glens Falls Country Club Membership Application Applicant s Name: Residence: Billing Address: Home Phone Number: DOB: Email Address: Cell Phone Number: Business Name: Business Address: Business Phone Number: Date of Employment:_ Occupation: _ Please check the box that describes your current domestic situation: Married I have a spouse of a marriage that is legal in the State of New York. Domestic Partnership I share a regular and permanent address with a partner/individual with the current intent of doing so indefinitely. Single I do not share a regular and permanent address with an individual and/or I am married but have a marital separation agreement that is legal in the State of New York. Interests (circle): Golf Paddle Tennis Pickleball Beach List affiliations you have with other private clubs both currently and/or past.
The Club, from time-to-time, may run promotions based on birthdays, anniversaries, etc. These promotions, as well as all of our events, newsletter and information are sent via email. Spouse/Partner Name: Cell Phone Number: Anniversary Date: DOB: Email Address: Business Name: Business Address: Business Phone Number: Date of Employment: Occupation: _ Interests (circle): Golf Paddle Tennis Pickleball Beach I/We have an unmarried dependent child or children under the age of 25 years that reside(s) with me/us: Yes No If Yes, please list your child s or children s information in the following table: Name DOB Interests (circle)
Type of Membership applying for (check all that applies): Social Membership: Includes dining privileges, beach, tennis, and paddle. Golf Membership Includes Social Membership plus Golf. Beach Membership Includes use of the beach facilities only. Why are you applying for membership at the Glens Falls Country Club? Have you ever been refused membership, suspended, expelled or asked to withdraw from membership in a private club or other membership organization? If yes, please explain: Please list Glens Falls Country Club Members with whom you are affiliated either currently or in the past:
Sponsored by the following Club Members (signatures): 1. Print Name 2. Print Name (Please note that a sponsoring Club Member may not be an active member of the Glens Falls Country Club s Board of Governors.) Acknowledgement: I acknowledge that I am applying for membership at a private club. While the Glens Falls Country Club will not discriminate in violation of any legally protected rights, it may exercise its very broad powers of discretion in determining who its members will be. To do so it will obtain and act on varying types and degrees of information about applicants. Such information may include, among other things, information about the applicant s character, general reputation, personal characteristics, and mode of living and financial condition. As a condition to my application being acted upon, I agree: (1) That the information I have provided in this application is true and correct; (2) That I am not entitled to have disclosed to me any information obtained or acted upon by the Glens Falls Country Club; and (3) The Glens Falls Country Club, its officers, directors, employees, members and committee members are released and held harmless from any claim or liability arising out of the information obtained about me or how it is used in deciding my membership application. Signature of Applicant: Date:
Membership I,, the undersigned, have recently submitted an application for Membership to the Glens Falls Country Club ( the Club ) dated. In connection with my aforementioned application for a golf membership, I am aware that the regular Initiation fee has been waived. In consideration of said waiver of initiation it is hereby expressly acknowledged and agreed that I shall be fully responsible for any and all dues, assessments and/or minimum expenditure requirements payable to the Club for a twelve (12) month period from the date of my acceptance as a Member. In that regard, I fully understand and agree that in the event I choose to terminate my membership, I will remain responsible to pay any amounts due, or to become due, during said 12-month period. I have willing accepted the waiver of initiation as outlined above in exchange for my commitment to remain a member for a minimum of 12 months, or, alternatively, to pay equivalent, dues, fees, assessments and/or minimums as might come due during said months. I further recognize that any letter of resignation which I submit within the first twelve months of membership may be rejected by the Club s Board of Governors until such time as I pay any remaining amounts owed under this agreement.