City Club at Lost Plantation
Family W/Cart Plan Enrollment
Dues are $400.00 and this is a monthly membership. ** Pro-Rated dues to join today are $226.67 **
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Primary Member
First Name
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Last Name
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Birth Date
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Gender
Male
Female
Phone Number
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Email Address
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Confirm Email Address
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Address
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City
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Select Country
Select State
Zip Code
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Sub Member 1
First Name
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Last Name
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Birth Date
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Gender
Male
Female
Relationship
Email
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Sub Member 2
First Name
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Last Name
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Birth Date
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Gender
Male
Female
Relationship
Email
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Sub Member 3
First Name
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Last Name
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Birth Date
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Gender
Male
Female
Relationship
Email
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Sub Member 4
First Name
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Last Name
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Birth Date
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Gender
Male
Female
Relationship
Email
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Staff Member or Referring Members Name at City Club at Lost Plantation
Maximum 128 characters allowed!
Family W/Cart Plan Terms & Conditions
All active membership accounts that are 60 days delinquent will be subject to suspension of membership and all playing privileges will be revoked until the account balance is settled.
With completion of this form, you are committing to an annual membership at City Club. All memberships will automatically renew on
January 1
unless cancellation request is received in writing.
I have read, understand and accept the terms and conditions of the Family W/Cart Plan.
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