* Please select from the following membership classifications:
Unlimited Golf Full Golf Associate Golf (Currently unavailable - waiting list) Social

I submit the following information for confidential consideration for membership:
* First Name: * Last Name:
*Birth Date: *Social Security #:
Spouse Name: Birth Date:
Child 1: Gender: Birth Date:
Child 2: Gender: Birth Date:
Child 3: Gender: Birth Date:
*Home Address:
*City: *State: *Zip:
*Home Phone: Cell Phone:
*Email Address:
*Billing Address:
*City: *State: *Zip:
Employed by:
Position: Business Phone:

Please provide a credit card to keep on file:
*Credit Card Type: Visa Master Card AMEX
*Card Number: *Expiration Date: /

I would like to charge my entry fee into the Club using the above credit card. Amount to Charge:
I would like to charge my monthly dues and account charges to the above credit card.

I agree to be responsible for the charges incurred by myself or my family. I agree to abide by all rules and regulations now in effect at the Club and any amendments thereto which may be made from time to time. I agree to remain a member for at least one year after which time I can resign by providing the Club with 60 days written notice. I understand that I am responsible for all dues and applicable fees during the 60 day notice period. If I should resign before one year, I agree to pay a $300 cancellation fee. Upon signing this application, I authorize the disclosure and release of information requested by the Club for investigating my qualifications for membership, including without limitation my credit history.

* Signature: * Date:
(Type your full name to electronically sign the form)
I was referred by: Membership #:
(A referral is not necessary for entry into the Club.)

Please complete the New Member Profile below. Thank you!

New Member Profile
This information will be used to help identify your needs as a member,
as well as assist in making sound marketing and customer service decisions.

1. What is your proximity to the Club?
Less than 5 miles
5-10 miles
10-20 miles
More than 20 miles

2. What is your age?
18-24
25-34
35-44
45-54
55-64
65 and over

3. Who in your household will be utilizing your Club membership?
Check all that apply
You
Spouse
Children or other dependents

4. What is the approximate value of your home?
(All information provided is confidential)
Less than $199,999
$200,000 - $249,999
$250,000 - $299,999
$300,000 - $349,999
$350,000 - $399,999
$400,000 - $449,999
$450,000 - $499,999
Over $500,000

5. Have you previously been a member of Ivy Hills or Royal Oak Country Club?
No
Yes

6. How do you plan to use the Club?
Check all that apply
Golf
Tennis
Swimming
Fitness
Social
Dining
Entertain Business Contacts

7. Have you visited either Club's website?
No
Yes

8. In what media have you seen or heard the Clubs advertised?
Check all that apply
Newspaper
Magazine
Radio
Television
Mailing
None

9. Would you or anyone in your family like more information about the following:

Check all that apply. A staff member or association leader will contact you via phone or email with additional information.

Men's Golf Association
Ladies Golf Association
Couples Golf Association
Singles Golf Association
Seniors Golf Association
Adult Golf Lessons
Junior Golf Lessons
Custom Golf Club Fitting
Getting a USGA Handicap
Adult Tennis
Junior Tennis
Adult Social Programming
Family Programming

I agree to the terms of Membership and would like to join .

Ivy Hills Country Club | 7711 Ivy Hills Blvd | Cincinnati, Ohio 45244 | Phone: (513) 561-9119

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