Old Pike Country Club · Current Member Update Form

Contact Information

Main Contact Name

*

Prefix

First Name

Last Name

Suffix

Main Contact Email

*

Verify Email

*

Home Phone

*

Cell Phone

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Organization/Employer

*

Secondary Contact Name

Prefix

First Name

Last Name

Suffix

Secondary Contact Email

Verify Email

Organization / Employer

*

Where does your spouse / partner work?

Child #1 Name

First Name

Last Name

Child #1 Birth Date

(mm/dd/yyyy)

Child #1 School

Child #2 Name

First Name

Last Name

Child #2 Birth Date

(mm/dd/yyyy)

Child #2 School

Child #3 Name

First Name

Last Name

Child #3 Birth Date

(mm/dd/yyyy)

Child #3 School

Child #4 Name

First Name

Last Name

Child #4 Birth Date

(mm/dd/yyyy)

Child #4 School

How did you hear about Old Pike CC?

*

Current Member

I Was a member as a child

Driving by the club

Reputation-word of mouth

Advertising

Internet

Other

Would you be interested in becoming involved at OPCC?

*

Please select the areas that may interest you or your family.

Swim Team

Dive Team

Tennis Team

Social Committee

Facilities Committee

Marketing Committee

Other

None

Photo of you or your family

A photo helps Old Pike identify the members in your database record. We may use your chosen photo as part of our collage of members in the future.

Application agreement

By clicking "SUBMIT" the applicant acknowledges the understanding of the terms below:

1. Until approved by the Board of Directors of Old Pike Country Club, the applicant is not granted membership benefits. The applicant may use the facilities as a guest and following all guest policies.

2. The applicant agrees to be follow all OPCC policies, procecdures, rules and regulations.

3. All membership payments must be made by one of the approved formats (monthly ACH withdrawl, or one-time check or ACH withdrawl, or one-time credit card payment) prior to membership benefits being granted.

4. All delinquent accounts will be processed for collection. A $25 fee will be charged for returned checks or returned ACH.

5. Membership is based on a calendar year. Dues are collected by monthly payment or in full by March 31st for the current year. If you terminate your membership with in a year you are responsihble for paying the balance of the year's dues.