PGA NATIONAL MEMBERS CLUB MEMBERSHIP …

1 PGA NATIONAL MEMBERS club MEMBERSHIP APPLICATION CANDIDATE INFORMATION Mr. Mrs. Ms. Dr. Primary Candidate_____ Today s Date / / Home Address_____Date of Birth / / City State Zip Home Phone ____Cell Phone _____Local Phone_____ Local Address_____ _____ _____ City State Zip Marital Status Single Married Wedding Anniversary Date _____ Social Security # (last 4 digits)_____ Driver s License # State (Copy to be provided at time of application) Business Name Type of Business Title _____ Length of Employment _____ (yrs)

2 Business Phone _____ Business Address_____ City_____ State_____Zip_____ Business E-mail _____ Personal e-mail _____Send club Emails to this address_____ Mr. Mrs. Ms. Dr. Spouse/Spousal Equivalent/Significant Other Date of Birth / / Social Security # (last 4 digits)_____ Driver s License # State Home Phone Business Phone Cell Phone Business Name Type of Business Title Length of Employment _____ (yrs) Personal e-mail _____Send club Emails to this address_____ List unmarried children under the age of 23 who reside at home: _____ Yes I/we have dependents as indicated below.

3 _____ No I/we do not have dependents residing with us. Name(s) Date of Birth Interests Charge Privileges / / Golf Tennis Yes No / / Golf Tennis Yes No / / Golf Tennis Yes No Online club Directory: Please indicate whether you would like to be listed in the Online club Directory, and which address and phone is to be listed: Yes No Address: Home Address Local Address Phone.

4 Home Phone Cell Phone INTERESTS: Check all that apply PLEASE BILL ME FOR: Check all that apply Men s Golf Association Men s Tennis ** Men s Golf Locker Ladies Golf Association Ladies Tennis ** Ladies Golf Locker Handicap Services Ladies Cards ** Men s club Storage Fitness Center Men s Cards ** Ladies club Storage MEMBERSHIP INFORMATION: I am/We are applying for MEMBERSHIP in the following Category: _____ _____FAMILY INDIVIDUAL Total Joining Cost : _____ Non-Refundable Portion** $_____ (+ tax) + Refundable Portion**: $_____ Current Annual Dues**: $_____(+ tax) Dues Prorated through October 31st: $_____ (+tax) **The combined total of the Non-Refundable Portion and Refundable Portion written above is the TOTAL actual amount paid by Member (or if paying in installments, the total amount required to be paid by Member in accordance with the terms of Member s promissory note or installment payment agreement).

5 Applicable sales tax, if any, not included. PALMER ADVANTAGE PLATINUM [Please initial YES or NO] Current Monthly Upgrade Palmer Advantage Platinum Dues** $_____ _____ YES, please enroll me/us in the Palmer Advantage Platinum benefit. With my enrollment, I/We agree to be bound by the terms and conditions of the benefits available at , I/We understand that I/we will be subject to payment of additional monthly dues in exchange for the Palmer Advantage Platinum benefit, which may be increased from time to time.

6 I/We also agree to pay any charges I/we incur at the participating clubs. I/We further agree to conform to and be bound by the Bylaws and Rules and Regulations of the participating clubs, all of which may be amended or modified from time to time. _____ NO, I/we am/are not interested in participating in upgraded Palmer Advantage Platinum benefits at this time. PGA NATIONAL MEMBERS club SPONSOR (PREFERRED) NAME PHONE # EMAIL ADDRESS _____ _____ _____ PERSONAL REFERENCES NAME PHONE # EMAIL ADDRESS _____ _____ _____ _____ _____ _____ OTHER club MEMERSHIPS club NAME CITY STATE _____ _____ _____ _____ _____ _____ PAYMENT OF MEMBERSHIP ACCOUNT I/We would prefer monthly statements to be mailed to.

7 Home Business e-mail Payment of MEMBERSHIP Account, including all dues, fees and other applicable charges, is due upon receipt of the monthly statement. If accepted for MEMBERSHIP , I/we agree to pay the account in full when due. I/We agree and understand that a late charge up to the maximum amount allowable by law, or other penalties, may be assessed for past-due accounts as provided for in the Bylaws and/or Rules and Regulations of the club , as amended from time to time. In addition to late fees, penalties may include, but are not limited to suspension of club privileges and/or expulsion from MEMBERSHIP .

8 I/we agree to maintain a valid major credit card on file with the club at all times. In the event that my/or account becomes more than ninety (90) days past due, club is hereby authorized to bill the card number on file. Payments on delinquent accounts shall be applied first to reduce late charges, then to reduce accrued dues and food & beverage charges (with the payment applied to reduce the oldest past due balances first), and then to any other charges. Any fees assessed for untimely payment of any applicable dues, fees or charges will appear on my/our statement. I/We agree to pay all reasonable attorneys' fees, investigator fees, and costs in the event this account is turned over for collection.

9 MEMBERSHIP POLICIES If accepted into MEMBERSHIP , I/we agree to conform to and be bound by the enrollment terms contained herein, the Bylaws, the Rules and Regulations, and written MEMBERSHIP policies of the club ( MEMBERSHIP Documents ) as they may be amended from time to time. I/We further understand that agreeing to be bound by the MEMBERSHIP Documents is a part of my/our agreement for MEMBERSHIP privileges with the club . I/We specifically understand this MEMBERSHIP is not divisible. I/We hereby acknowledge receipt of a copy of the Bylaws and/or the Rules and Regulations of the club .

10 I/WE ACKNOWLEDGE THE MEMBERSHIP BYLAWS AND THE RULES AND REGULATIONS PROVIDE THE DETAILS OF THE club S MEMBERSHIP POLICIES, CONDUCT AND OBLIGATIONS, INCLUDING, BUT NOT LIMITED TO, PROVISIONS IN THE EVENT OF DIVORCE, FOR ARBITRATION OF DISPUTES, RESIGNATION, REDEMPTION OF MEMBERSHIPS, FINANCIAL OBLIGATIONS, DISCIPLINARY ACTION, RELEASE OF LIABILITY FOR PERSONAL INJURY AND THEFT. I/WE HEREBY FULLY RELEASE AND DISCHARGE THE club , ITS EMPLOYEES, AGENTS, SHAREHOLDERS, MEMBERS , MANAGERS, AFFILIATES AND ASSIGNS FROM ANY LIABILITY, INJURY, LOSS, DAMAGE OR CLAIM ARISING FROM MY/OUR USE OF THE club FACILITIES.