Ivy Hill Pickleball Membership Packet

2021 Pickleball Membership Packet

Ivy Hill Golf Club:

1148 Ivy Hill Drive, Forest, VA 24551 (434) 525-2680 info@ivyhillgolf.com

Ivy Hill Pickleball Membership Form Pickleball members enjoy unlimited pickleball court access, access to social events and club activities, the ability to bring guests at a set daily rate, and club account charging privileges.

Pickleball Membership Options MEMBERSHIP TYPE

# PEOPLE

PUBLIC RATE

IVY GOLF MEMBER RATE

Individual Membership

One person

$225

$180

Family Membership

Up to 5 people

$350

$280

Additional Family Members

$50 per person

$40 per person

Two people, same household

$275

$220

Couple Membership

Payment in full or completed credit card authorization form must accompany the pickleball membership application.

Member Information: Full Name: ________________________________ Email Address: ________________________________ Home Address: ________________________________ City:________________ State:____ Zip:________ Home Phone #: (_____)______________ Cell Phone #: (_____)______________ Date of Birth: __/__/_____ Referred by:

Member: ___________________

Facebook

Website

Other:_______________

Ivy Hill Pickleball Membership Form

Primary Member’s Name: Current Ivy Hill Golf Member? Yes or No (circle one) For Family or Couple Memberships Only: Spouse’s Name: Children’s Names and Birthdates:

Additional Family Members: $50.00 per person fee ($40 for golf members) will apply

I understand that all guest must pay a daily guest fee of $7.00 per person and that the pickleball member is responsible for their guests. I understand that if I charge on my member account that I must pay this balance off each month and that the balance must be paid in full by the last day the pickleball courts are open.

Signature: Printed Name: Date:

Automatic Payment Authorization Form Please select your desired membership(s): (select all that apply) Ivy Hill Pickleball Membership Ivy Hill Pool Membership

Member’s Name:

Credit Card Number:

Expiration Date:

CVV Code:

Billing ZIP Code:

I authorize R&P Golf Companies, Inc. to process my credit card listed above for my monthly membership dues and any charges on my member account from the previous month. Cards will be processed on/around the 15th of each month. If my credit card is unable to be processed on the due date, I understand that I must provide an updated credit card or submit payment within 5 business days, using another payment method. Initial here:

Printed name on the credit card:

Authorized signature for credit card: