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TO: Membership Committee (to be delivered to the club secretary): I hereby submit my application for membership in the Island Country Club, a Florida Not-For-Profit corporation, and agree to pay a membership fee in existence at the time of my admission as a Member and, further, I understand that if approved for membership, that: 1. I am purchasing a membership in the Club for the purpose of obtaining a right to use and enjoy the Club facilities and not for the purpose of investment. As a Not-For-Profit corporation, the Club will have no capital stock and will not be operated for pecuniary gain or profit. There will be no payment of income, dividends or other distribution to any members, except upon dissolution, and the members will have no interest in or title to any of the property or assets of the Club. I do not expect to derive any economic profits from any membership. 2. My right of refund of my membership fee will be restricted as set forth in the Bylaws or by the Board of Directors 3. The Board of Directors will be responsible for the administration of the Club and will have authority to accept members, establish membership fees, set annual dues, establish rules and regulations and control the management and affairs of the Club in accordance with the Articles of Incorporation and Bylaws of the Club. 4. While on the waiting list, if no opening is available, I agree to become a Social/Social Tennis Member and pay the applicable dues. 5. I, the applicant, acknowledge the receipt of the Island Country Club Bylaws and agree to comply with and be bound by the Membership Rules and Regulations as may be amended from time to time. I am pleased to provide the requested information, in order that the Membership Committee may properly review my application for membership. This information is to be kept strictly confidential. MEMBER NUMBER: _____________ Information on Prospective Member PLEASE PRINT CLEARLY AND FILL OUT ALL SECTIONS COMPLETELY Name_________________________________________________ Golf Hdcp or Avg. Score_______________ Address (Northern Residence):________________________________________________________________ _________________________________________Telephone Number:________________________________ Address (Florida Residence):__________________________________________________________________ _________________________________________Telephone Number:________________________________ E-Mail Address____________________________________________________________________________ Date of Birth:______________________________ Tennis Player: Yes_____ No_____ NTRP Rating ________ Spouse’s Nam e:_________________________________________ Golf Hdcp or Avg. Score _____________ Tennis Player: Yes_____ No_____ NTRP Rating________ E-Mail Address___________________________________________________________________________ Spouse’s D ate of Birth:__________________________ Anniversary Date:_____________________________ 2
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