MEMBERSHIP FORM

I,

Surname __________________ Name_________________

Born ______________ DOB_____________ Nationality__________________

Currently residing ___________________ Street__________________ n._____ Postal Code_______

Phone Off.______________ Phone Home________________ Fax________________

E-mail ___________________ CF________________________

Studies ___________________ Profession ___________________________

Already golf player

Exact hcp ________ n. F.I.G.______________

Last Golf Club __________________  (attached the cancellation of federation subscription at previous club).

Not currently golf player

Prefered method of contact: Tel. Fax / Post E-mail

I would like to become a member of *____________________and enclosed
is my medical certificate for sporting activities.

I finally declare:

1) To have read and understood the rules and regulations of Chia Golf Club, of the prices and membership rules of subscription of Chia golf club,I accept and agree to honour these rules;
2) To pay the membership fees before the 31st October of every year for the following years;
3) To give notice of possible cancellation of membership at least 90 days in advance of the 31st December;
4) To give my authorization of the details provided by myself to be used under the law n. 675/96.

Chia, date Signed __________________

*effective practice ground-pitch&putt; spouse full member practice ground- pitch&putt; other club practice ground-pitch&putt; juniors (up to 20 years)-university students (up to 25 years) practice ground-pich&putt; effective practice ground; juniors (up to 20 years)-university students (up to 25 years) practice ground.