Membership No. :
Membership Application Form 2016/17 (August-April inclusive)
Please complete all sections
Name : __________________________________________________
Title : ___________
Contact Address: _________________________________________________________________
___________________________________________________
Telephone Number: Home:______________________
Email Address:__________________________________
Postcode: _________________
Mobile: ______________________
Occupation: ____________________
Date of Birth: _________________________ Date of Initial Joining: ________________________
Membership Details
Are you a member of another club? ________
Club Name : _________________________
How long have you been playing golf? ______________________________________________
What is your Handicap? __________________________________________________________
CDH Lifetime ID__________________________________________________________________
PLEASE NOTE: This Membership is a fixed amount for the period stated. On signing this form you
agreeing to pay the full amount indicated in a maximum of 3 payments. 1 x August, 1 x September
and 1 x October 2016. No refund in whole or part of the Membership fee will be payable in any
circumstances. On signing this form you are agreeing to pay the whole amount. Failure to do so by
the last day of each month will result in a breach of contract and will be referred to a third party for
collection.
Type of membership: Circle as appropriate
Gold £410.00 Silver £320.00
Bronze £300.00
Colt £175.00
.
Terms & Conditions
All persons using the golf course and driving range do so at their own risk. Basset Down Golf Course accepts no liability for damage,
injury or loss to any persons or property however caused. Persons using the golf course should ensure they have their own personal
liability insurance.
Data Protection Act Notice – A condition of joining is your agreement for Basset Down Golf Course to hold all details relating to your
membership. We will not use these for any other purpose or share them with other parties.
Car Park Persons using the car park do so at their own risk. Basset Down Golf Course cannot be responsible for any damage, injury or
loss to any person, vehicle or the contents.
The proprietors of Basset Down Golf Course reserve the right to exclude any person from the golf course and driving range at any time,
even if the person has paid a green fee or is a member. The proprietors of Basset Down Golf Course and Driving Range reserve the right
to alter the green fees and range fees at any time.
Applicant’s signature: _______________________________________
Date:
For Office Use :
________________________________________
Input on Website: _____ DB_________ BRS _______ LC _______ Issue Tag/LC: ______
Membership No. :
Membership Type
GOLD
SILVER
BRONZE
COLT
JUNIOR
Single
Total amount due
Full or Split Payment
Date of Payment 1
Amount of Payment
Method of Payment
Taken by whom
Date of Payment 2
Amount of Payment
Method of Payment
Taken by whom
Date of Payment 3
Amount of Payment
Method of Payment
Taken by whom
For Office Use :
Input on Website: _____ DB_________ BRS _______ LC _______ Issue Tag/LC: ______