| MARYSVILLE GOLF CLUB | ||||||||||
| 13683 STATE ROUTE 38 | ||||||||||
| MARYSVILLE, OHIO 43040 | ||||||||||
| TEL : 937-642-1816 FAX : 937-642-6882 | ||||||||||
| Application for 2010 Annual Pass | ||||||||||
| NAME : | ||||||||||
| HOME ADDRESS : | ||||||||||
| TEL (HOME) : | ||||||||||
| TEL (WORK) : | ||||||||||
| E-MAIL ADDRESS : | ||||||||||
| Pass Dues : (NO TAX) | $ | |||||||||
| CART FEE DUES : (TAXABLE) | $ | |||||||||
| SCORE SYSTEM (GHIN) : (TAXABLE) | $ | |||||||||
| SALES TAX (6.75%) : | $ | |||||||||
| GRAND TOTAL | $ | |||||||||
| FAMILY NAMES : | ||||||||||
| (Please Print) | ||||||||||
| I understand that this priviledge is subject to acceptance by the Marysville Golf Club. I understand that this is not a | ||||||||||
| membership in the Marysville Golf Club. The Marysville Golf Club reserves the right to terminate this priviledge for | ||||||||||
| conduct deemed innappropriate and or abusive to the course rules, regulations and staff. If termination occurs, | ||||||||||
| No refunds will be given. Also I red and agreed with annual pass's terms and conditions. | ||||||||||
| PAYMENT IN FULL REQUIRED AT TIME OF APPLICATION | ||||||||||
| OFFICIAL USE ONLY | ||||||||||
| PASS NO. | 2010- | |||||||||
| SIGNATURE : | PAID DATE : | |||||||||
| PAID BY : | ||||||||||
| DATE : | SOLD BY : | |||||||||