Revised 3-24-11
LANCASTER
GOLF CLUB MEMBERSHIP APPLICATION
APPLICANT INFORMATION
Primary Member Name:
Date of birth: / / Home Phone: ( ) Cell Phone: ( )
Current address:
City: State: Zip: Gender (circle): Male or Female
Email address:
MEMBERSHIP TYPE & BILLING OPTION
Membership Type (circle): Individual Family Weekday Individual
Student Weekday Couple
Billing Option (circle): Monthly Draft 1st Monthly Draft 15th Quarterly Monthly Credit Card Charge 1st
Would you like to receive bills/receipts via e-mail? (circle): Yes No
EMERGENCY CONTACT
Name: Relationship:
Home Phone: ( ) Work Phone: ( ) Cell Phone: ( )
SPOUSE INFORMATION IF JOINT MEMBERSHIP
Name: Gender (circle): Male or Female
Date of birth: / / Cell Phone: ( ) Work Phone: ( )
Email address: Current employer:
SIGNATURES
I further agree to release, hold harmless, defend, and/or indemnify Leroy Springs & Company, Inc. (LSC), its directors, officers, employees, and agents, from any and all liability, claims, demands, actions, and causes of actions whatsoever arising out of or related to any losses of personal property, damage or any bodily injuries incurred or suffered by persons listed on this application, while on properties owned by LSC, or when participating in programs sponsored or otherwise organized by LSC. I hereby grant LSC the right and permission to take and use photographs and/or sound image/recordings of any person listed on this application to use for the promotion of advertising and marketing activities of LSC. I understand that no monetary payment
will be made for such uses. I release LSC from all claims, for any cause of action arising out of taking and/or use of such images or recordings.
Signature of applicant: Date:
OFFICE USE ONLY
[ ] APPROVED HH# RATE $ /MONTH DATE LETTER SENT
Revised 3-24-11
LANCASTER
GOLF CLUB MEMBERSHIP APPLICATION
FOR FAMILY MEMBERSHIP – PLEASE LIST CHILDREN
Child1 Name:
Date of birth: / / Home Phone: ( ) Cell Phone: ( )
Current address (if different from Primary) :
City: State: Zip: Gender (circle): Male or Female
Email address:
Child2 Name:
Date of birth: / / Home Phone: ( ) Cell Phone: ( )
Current address (if different from Primary) :
City: State: Zip: Gender (circle): Male or Female
Email address:
Child3 Name:
Date of birth: / / Home Phone: ( ) Cell Phone: ( )
Current address (if different from Primary) :
City: State: Zip: Gender (circle): Male or Female
Email address: Child4 Name:
Date of birth: / / Home Phone: ( ) Cell Phone: ( )
Current address (if different from Primary) :
City: State: Zip: Gender (circle): Male or Female
Email address:
Child5 Name:
Date of birth: / / Home Phone: ( ) Cell Phone: ( )
Current address (if different from Primary) :
City: State: Zip: Gender (circle): Male or Female
Revised 3-24-11
Lancaster Golf Club Membership Rules and Regulations
A. MEMBERSHIP REQUIREMENTS:1. Lancaster Golf Club reserves the right to limit memberships, and to give preference to those who live and work within Lancaster and surrounding counties.
2. Memberships at Lancaster Golf Club are available under multiple categories. For the purpose of Family Memberships, membership includes spouse and unmarried dependent children attending school or in the military and under the age of 25. Evidence will be required of a full time student for all high school graduates and for military dependent membership.
B. MEMBERSHIP PRIVILEGES:
1. The privileges hereby conferred on a membership include only the use of the golf course operated by LSC d/b/a Lancaster Golf Club, 1821 Springs Club Road, Lancaster, SC 29720, subject to these rules and regulations. A
membership is strictly of a non-proprietary nature and does not confer upon the holder thereof any ownership of interest in the land, improvements or assets of the Lancaster Golf Club. The holder of membership shall not be subject to any assessments or any liabilities of Lancaster Golf Club. Any other facilities or services, which may be available at Lancaster Golf Club, may only be used by holder of membership upon payment of customary charges set forth for such services at facilities provided.
2. Members have discounted privileges at LSC sister courses, including Chester Golf Club, Fort Mill Golf Club and Springfield Golf Club. Fees are set on an annual basis; date and time restrictions will apply.
C. RESIGNATION:
1. Any member shall be permitted to resign at any time by tendering his or her notice of resignation in writing to Leroy Springs & Co. Such resignation will be effective on the last day of the month in which the resignation was tendered and dues will be paid accordingly. Members who resign their membership will not be considered for reinstatement for 12 months following such resignation.
2. Suspension of memberships for medical reasons may be approved by the Director of Golf on a case-by-case basis for members in good standing. Members with medical suspensions will not be liable for dues accrued during such
suspension.
D. PAYMENT OF DUES AND INDEBTEDNESS:
1. Dues shall be due and payable monthly in advance together with any indebtedness incurred by the member for any merchandise purchased or facilities or services used, or late fees during any prior period. If the payment of such dues and all such indebtedness is not made on or before the fifth day of the month, LSC at its discretion may suspend or cancel the membership of any such delinquent member. Cancellation of membership shall not relieve such delinquent member from liability for all monthly dues incurred prior to date of cancellation of such membership, or for liability for all indebtedness owed to LSC.
E. CANCELLATION OF MEMBERSHIP FOR CAUSE:
1. In addition to cancellation of membership pursuant to the provisions of ARTICLE A and ARTICLE D above, membership may be cancelled by LSC at its sole discretion in the event of the flagrant violation by a member of these rules and regulations, conduct detrimental to the use of the golf course by others, and/or failure to abide by rules and regulations of the golf course.
F. OBSERVANCE OF COURSE RULES & MISCELLANEOUS:
1. It is understood that Lancaster Golf Club may fix from time to time rules and regulations concerning the use of the golf course, the conduct of players and reasonable limitations required on play on the golf course during specific days, such as specific days set aside for male golfers or women golfers and restricted play at certain times by reason of tournaments scheduled by the golf course. All members shall abide by all such rules and regulations as shall, from time to time, be fixed by LSC.
2. It is the duty of each Member using the facilities to familiarize him or herself with and observe the rules of etiquette as required in the rules of the U.S.G.A.
3. Members recognize that it is the responsibility of all golfers, including members, to care for the course. Divots shall be
filled with material provided on tees and in carts; ball marks are to be repaired on greens; and bunkers are to be raked after use.
4. While using the Lancaster Golf Club and/ or its Facilities for any reason, members shall not display rude or offensive behavior. When a member is using or occupying Club Facilities, the Lancaster Golf Club shall have the sole right to adjudge behavior as rude or offensive using generally accepted standards of decorum.
5. It is understood that play at the Lancaster Golf Club is not limited to the holders of membership and is open for public play. Lancaster Golf Club, to the extent possible in the orderly operation of its golf course, shall endeavor to give starting time preference to members of the course but it is specifically understood that any such preference shall be entirely at the discretion of course management.
G. CHANGES:
1. Lancaster Golf Club reserves the right to make necessary changes and updates to these Rules and Regulations at any time.
H. NOTICES:
1. All written notices required to be given to a member may be given either by delivering such notice personally to a member or by placing such notice in the United States mail, postage prepaid, addressed to member at the mailing address shown on member’s application for membership. Alternatively, such notice may be sent by e-mail addressed to member at the e-mail address shown on member’s application for membership, as updated by the member with the golf club.
I have received and agree to abide by these Rules and Regulations:
LEROY SPRINGS & COMPANY, INC.
AUTOMATIC DRAFT PROGRAM (ACH FORM)
Leroy Springs & Company, Inc. is pleased to offer you the preauthorized payment plan service for your
convenience. Your monthly loan payment will be automatically deducted from your checking or savings account
each month. This plan allows us to better service your account.
Instructions:
Complete the Automatic Debit Authorization Form on this page and make a copy of the completed authorization
form for your records. If you are using a checking account for automatic debit, you must attach a voided check
(not a deposit slip) from that account. If you are using a savings account, you must provide your bank ACH
routing number and your savings account number. The bank ACH routing number can be obtained from your
bank.
In order for your request to be processed, you must:
Forms can be mailed to:
- Complete this form - all items must be completed.
Leroy Springs & Company, Inc.
- Submit a voided check to draft your checking account.
P.O. Box 1209
- Provide the bank ACH routing number.
Fort Mill, SC 29716
Attention: Accounting
AUTOMATIC DEBIT AUTHORIZATION
I authorize Leroy Springs & Company, Inc. (LSC) to initiate electronic debit entries and to initiate, if necessary, credit entries and adjustments for any debit entry errors to my checking account or savings account indicated below. I authorize the financial institution named below to debit and/or credit these entries from my account. These payments will be debited each month as indicated below.
This authorization is to remain in effect until I notify LSC in writing of its termination. To cancel this automatic debit, I must provide written notice of cancellation to LSC not less than 10 days prior to the next scheduled automatic draft. LSC may terminate this payment plan upon notice of two (2) non-sufficient funds transactions. LSC reserves the right to cancel this agreement with prior written notice. LSC will notify me of any changes in the dollar amount debited from my account. LSC shall not be liable for losses caused by the financial institution's failure to act in accordance to this request.
Customer Name (Please Print)
Home Address City State & Zip Code
Location: Chester Golf Club ( ) Fort Mill Golf Club ( ) Recreation Complex ( )
Lancaster Golf Club ( ) Springfield Golf Club ( ) ASC Greenway ( )
Fort Mill/Springfield Golf Club Joint ( )
Type of Account to be Drafted (Check One): (
) Checking
(
) Savings
Transfer Date (Check One): ( ) 1st ( ) 15th
Note: If the 1st or 15th falls on a weekend or holiday, the automatic debit will be processed on the next business day.
Financial Institution Name
ABA Transit Routing Number (9 Digits) Account Number
Customer Signature Date
Account Holder Signature (if different from Customer) Date
