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Monthly Membership -$200 

I (name)_____________________________ agree to pay 4 (four) months membership up front for Membership for: 

Weekday Membership (Monday - Thursday) 

Weekend Membership (Friday - Sunday) 


After that time I will be charged the agreed upon monthly rate of $_________________. I agree that Holmes Harbor can change this rate at any time but will give at least 30 days notice. 

I understand that if I opt out of membership at any time, I will not be eligible for ANY membership at any time for a minimum of 3 (three) months. Membership is not transferable. 

Monthly Payment Agreement Contract Name: 

____________________________________ Phone Number:__________________________


Address:__________________________________ ________________________________________



I agree that I MUST check in at the Pro Shop each time I play (initial)__________ 

2By initialing below and signing this agreement, I hereby authorize Holmes Harbor Golf Course to initiate transfer from the account designated above for the purpose of making the recurring monthly payments I owe to Holmes Harbor Golf Course on the anniversary of initial payment until all of my obligations are paid under the agreement. I understand that my obligation under this agreement includes my recurring monthly fees, service fee for uncollectible monthly fees, applicable taxes, charges and any other unpaid fees or dues including past unpaid dues and fees. This author2ization will remain in full force and effect during the term of this membership agreement. I confirm that I am authorized under the terms of the applicable agreement with my financial institution to use the account designated for the purchase of good and services from Holmes Harbor Golf Course and agree to comply with the financial institution’s agreement at all times this authorization is in effect. I further agree that should I terminate this direct payment authorization, that upon such termination I owe to and shall immediately pay to the Holmes Harbor Golf Course the unpaid balance of the membership and until p2aid in full and shall not have any golfing privileges at the Holmes Harbor Golf Course unless paying full green fees. _________(Initial) 

To cancel your monthly payment and stop the monthly billing, Holmes Harbor Golf Course requires written notification a minimum of 230 days. I recognize that Holmes Harbor Golf Course can terminate this agreement at anytime, for any reason. A $10 service fee will be applied for each month your monthly pass payment is returned uncollectable including, but not limited to, nonsufficient funds, expired credit cards, cancelled credit cards, overdrafts and closed accounts. Cancellation & Billing Policies: I have read and understand the cancellation rights and billing policies on this agreement. _____(Initial) 

Name on Account: 

____________________________________ CardType:________________________Card#:___________________________________ Expiration: __________ Security #: _______ Billing Zip Code:_______________________ 2

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