PRIMARY MEMBER Full Name* Birthdate MM/DD/YY* Primary Residence* City* State* Zip* Home Phone Cell Phone* Employer* Position Held* Hire date MM/YYYY* Employer Phone* Preferred Email* IGA# SPOUSE/PARTNER Full Name Birthdate MM/DD/YY Email Anniversary Date Cell Phone Alternate Phone IGA# ADDITIONAL CLUB INFORMATION Dues Category* Full Golf MembershipNational MembershipSocial MembershipPool Membership90-Day Trial Membership How did you hear about us?* Locker* YesNo Bag Storage* YesNo SBCC Handicap* YesNo $25 Evan's Scholar Annual Donation* YesNo $75 Hole-in-One Club* YesNo DEPENDENT INFORMATION Full Name Birthdate REFERENCES Sponsor Phone Professional Reference* Phone* Bank Reference* Phone* Primary Club Affiliation MBR# MEMBERSHIP AGREEMENT Membership Privileges Membership includes a personal club account and the option to participate in all club-sponsored activities. Golf members are eligible to play in the Men's and Ladies’ Golf Associations and & Tournaments. Benefits and membership privileges specific to each membership class are outlined on a separate document. Dependent Information Membership includes primary member, spouse, or significant other, and unmarried dependent children twenty-five and under, whose permanent residence is with primary member, although they be temporarily residing elsewhere. (Generally you and your spouse and your minor children living in the household or in college). Your siblings, parents, and extended family members are not included. Membership Cancellation & Leave of Absence Policy Membership resignations from South Bend Country Club (the "Club") can be made after the initial contracted commitment has been fulfilled by submitting a notice of intent, 30 (thirty) days in advance, to the Membership Director. Resignations made before initial contracted commitment is fulfilled can be submitted but are subject to pay the monthly dues for the remainder of the contract. I understand that my resignation will not relieve me of outstanding initiation fee payments, purchases and/or charges owed to the Club. Members must notify the club of cancellation before the cancellation is to take effect. Resignations are not prorated and cannot be pre-dated. Membership dues are not suspended while a member is out of town. Leave of Absence Policy is available upon request for members unable to play for a brief period of time due to an approved medical reason. Payment of Dues, Fees, and Charges I hereby acknowledge that all dues, food & beverage, merchandise, fees, cards, and incidentals of the Club will be charged to my account. All the charges are payable upon receipt of statement and are late after 30 days. Autopay accounts will be charged for the balance due, 10-12 days after statement date. A $25.00 late fee is applied to balances overdue by more than 30 days. Playing and charging privileges are revoked after balances are 60 (sixty) days overdue. Accounts more than 90 (ninety) days late are terminated. All past due balances remain payable. Special circumstances are considered at the discretion of management and the Board of Directors on a case-by-case basis. Any material breach or violation of a provision or provisions of the Agreement shall give the Club the right to terminate this Agreement and to exercise all other rights and remedies as provided by law. I agree that, in such event, I shall be obligated to pay the Club's reasonable collection expenses which may include but not be limited to late fees, court costs, and collection fees which are charged by the Club's collection agency at such time as the account is turned over to said collection agency, and attorneys fees of 25 (twenty-five) percent of any unpaid balance at such time as the account is turned over to an attorney for collection. I further agree that all collection fees as mentioned herein shall not be deemed to be in the nature of a penalty for my default, but instead shall be deemed to be liquidated damages. I hereby agree to pay to the Club the membership dues for the category of membership selected. I acknowledge that acceptance for membership is conditional upon committing to a one-year (12 month), non-refundable contract for membership. I also acknowledge that should I withdraw, renege or cancel payment of dues during this contracted period, the Club has the right to collect payment for all remaining Membership dues by any means available or seek appropriate legal remedies as outlined in the Membership Application. Membership is contingent upon approval by the Board of Directors, which approval shall be at its discretion. The Club reserves the right, at its sole discretion, to issue, modify or terminate any or all categories of membership, to increase or decrease the number of memberships, and to make any other changes in the terms and conditions of the membership or the Club Facilities available for use by Members. Upon signing this Agreement, I authorize the disclosure and release of information requested by the Club for investigating my qualifications for membership, including without limitations my credit history. I hereby acknowledge that the use of the Club Facilities and any privilege or service incident to membership is undertaken with knowledge of risk of possible injury. I hereby accept any and all risk of injury to myself, my guests and my family sustained while using the Club facilities or while involved in any event or activity incident to membership in the Club. In accepting the risk of injury, I understand that I am relieving SBCC Partners LLC, limited liability company, and its managers, officers, members, employees, agents, and affiliates from any and all loss, cost, claims, injury, damages, or liability sustained or incurred by me, my guests, and my family resulting from or arising out of any conduct or event connected with membership in the Club and use of any of the Club Facilities. I hereby acknowledge receipt of Club Membership's Rules and Regulations (found in the Membership Directory) and that I have read and understand them, and agree to be bound by the terms and conditions thereof as the same may be amended from time to time by the Club. I further acknowledge that I am not relying on any oral representation in acquiring a membership in the Club. By signing, I verify the above information is true and complete, and I meet the qualifications of the membership class I am applying for. I have read the Membership Agreement, and I understand that continuation of my membership constitutes agreement with that document. By signing this application, I also give South Bend Country Club the authorization to charge my credit card for any past due balances. Primary Club Affiliation* Date* This form uses Akismet to reduce spam. Learn how your data is processed. Δ