Kirkland Lake Golf Club Limited

P.O. Box 205 Kirkland Lake, Ontario P2N 3H7

www.klgolfclub.com
HST # R128844628RT0001

Membership Fees for 2014 Season

Member Name: Address: Address: Town/City: Postal Code: Phone Number: Email Address: Memberships
Adult Junior (18 & Under) Student (19-25 Attending School)

Rate
$785.00 $200.00 $300.00

Member Name
$ $ $

Ext Amount

Family Rates
Add your Spouse Add your Child (Junior) Add your 2nd Child (Junior) Add your 3rd Child (Junior) Add your 4th+ Child (Junior)

Rate
$600.00 $150.00 $125.00 $100.00 $50.00 ea

Family Member Names

$ $ $ $ $

Ext Amount

New & Returning Rates

New Adult (1st time KLGC Member) Returning Adult (Conditions apply) New Junior (1st time KLGC Member) New Student (1st time KLGC Member)

Rate
$600.00 $700.00 $150.00 $225.00

Member Name
$ $ $ $

Ext Amount

Other Memberships
Associate Membership (Conditions apply) Out of Town Membership (Conditions apply) Club Storage Cart Usage Fee (Gas) Cart Usage Fee (Electric) Driving Range Membership Payments by Credit Card

Rate
$350.00 $350.00 $70.00 $210.00 $275.00 $125.00 $25.00

Member Names
$ $ $ $ $ $ $

Ext Amount

Corporate Sponsorships
Hole Sponsorship Tee Block Sponsorship Scorecard Advertising Rental Cart Advertising Other Sponsorships Other Advertising

Rate
Consult KLGC Executive Consult KLGC Executive Consult KLGC Executive Consult KLGC Executive Consult KLGC Executive Consult KLGC Executive

Sponsorship/Advertising Details
$ $ $ $ $ $

Ext Amount

Subtotal $ 13% HST $ $ Total

Office Use Only Method of Payment Cheque __________ Interac __________ Cash __________ Post Dated Cheques June 1, 2014 __________ July 1, 2014 __________ August 1, 2014 __________ Received by __________________________________ Date : __________________________________