Membership Application Form

Membership Type*

Family Golf
Single Golf
Social
Junior Single Golf
Junior Family Golf
Junior Social

Your Name*

First Last

Spouses' Name*

First Last

Marital Status*

Married
Single

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Cell Phone*

Would you like to receive text messages for Brown's Run?

Yes

Email*

Member's Date of Birth*

Spouses' Date of Birth

Children: The children who qualify as dependents on your membership

Name	Date of Birth

Consent*

I have read and fully understand this membership commitment

Membership Commitment:
I understand that memberships are annual commitments based upon the club’s fiscal period, April 1st – March 31st. If membership is granted after the commencement of any membership year, the dues will be prorated and your membership will be obligatory until March 31st of the following year. I understand and agree that I am required to remain a member and pay all related dues, food minimums, fees, and any late charges related to my classification of the membership until March 31st.
Golf and Social memberships automatically renew and are binding with the payment of April’s membership dues which are billed on the March member statements. Payment of April dues is binding for a full membership year. Further, I understand that Brown’s Run Country Club will not grant a resignation or
change in membership classification prior to March 31, for any membership year, and I am obligated to pay the number of dues amount not less than the full annual amount of current dues relative to my classification of membership. Any changes to membership classifications, including resignations, must be submitted in writing no later than March 1st of each year.
I understand that dues are not locked in and maybe increased, once on an annual basis, based upon the
club’s fiscal calendar starting on April 1st. The food minimum is a $600 annual obligation that can be billed upfront in the form of a food credit or monthly at $50/month. Any unused food credit is forfeited at the end of the membership year.

I elect to pay the food minimum:*

Annually ($600 one-time fee on April 1st)
Monthly (12 installments of $50)

Consent*

I agree to remain a member for a full membership year following any promotional membership offer accepted.

MEMBERSHIP DUES ARE AN ANNUAL OBLIGATION for A 12-MONTH PERIOD STARTING APRIL 1st and CONCLUDING ON MARCH 31st.

Please select your billing option:*

Monthly Rate
Annual Rate
Initiation Fee (paid up front) $250

Consent*

I agree to keep an active credit card on file at all times during my membership at Brown’s Run. Furthermore, I authorize Brown’s Run to charge my credit card on file for any unpaid dues, usage, food minimums, or other charges including late fees once my account becomes more than 60 days in arrears.

I elect to make all payments to Brown's Run in the form of:*

ACH Monthly Debit (please complete ACH form and provide a voided check)
Credit Card on File
Personal/Business Check that I will mail in on or before 15th of each month

All monthly statements will be e-mailed electronically unless paper statements are specifically requested.

Photo Consent*

I give Brown's Run permission to take and use photos for the purpose of social media, newsletters, and use around the clubhouse.

Bylaws, Rules, and Regulations*

I hereby make application for membership into Brown's Run Country Club and agree to abide by the Bylaws, Rules, and Regulations as they are written and any amendments hereafter. I agree to pay my account promptly within 15 days of receipt and no later than its due date, to pay applicable initiation fee, all membership dues, fees and charges applicable to my classification of membership and all that may be assessed on any of said charges. I hereby certify that all information contained in this application is true and correct and I authorize Brown's Run Country Club to obtain, from whatever source deemed appropriate, all information necessary to verify statements contained herein, including a verification of my credit history. Applicant also agrees to accept full responsibility for the conduct and actions of his/her family & guests including remuneration for physical damages to the Clubhouse, Course, Carts, and grounds because of negligence and/or malfeasance of said family members and guests.

Signature*

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