2013 Summer Membership Program
March/April Newsletter
Mission StatementIndian River Club's
Guiding Principles
Home Golf Real Estate Membership Amenities Find Us Sign In NEW! Stay & Play
Membership Information Members' Home Towns Summer Membership Application Membership Inquiry
  

 

  

 Summer Membership Application

   
 Type of Membership:                                                      Individual                      Family                  
   
 Member Name:   
Local Address:       State      Zip
Billing Address:       State      Zip
Local Telephone:   
Email Address:   
Name of Spouse:   
  

Business 

        Applicant's  
             Occupation: 

                                                     Title:   
Company Name:     Telephone:  
Address:      State      Zip
Spouse's   Occupation:     Title:  
Company Name:      Telephone: 
Address:        State      Zip
  

 Children 

  

 Unmarried Children of Applicant: Twenty-One Years of Age or Under Living at Home:

Name:        Date of Birth:     Male/Female:     Attending School:
Name:        Date of Birth:     Male/Female:     Attending School:
Name:        Date of Birth:     Male/Female:     Attending School:
Name:        Date of Birth:     Male/Female:     Attending School:

 

 

   
Indian River Club Acquaintances (If Any)

Name:  

 

Name:  
Name:  
  


Other Club Memberships
(Present & Former, Please List All)

Name of Club:     Address:     Telephone: 
     Address:     Telephone: 
     Address:     Telephone: 
  


Verification of Agreement:

 

Upon signing this Application, Applicant and Applicant's Spouse (if any) each authorize the disclosure and release of information to the Club for investigating qualifications for membership, including without limitation, credit histories, and authorize those persons or entities listed herein to furnish information to the Club.  Applicant and Applicant's Spouse each agree that all information and communications received by the club are privileged, confidential and not subject to disclosure to the undersigned or to any other person other than authorized Club personnel.  The undersigned each agree never to make demand on the Club or any other person to disclose any of the information or communications to the undersigned, and the undersigned releases the Club and its members, partners, officers, directors, shareholders, employees, representatives, affiliates and agents and any person providing information or communications from any liability in connection therewith.

This application shall be governed by and construed in accordance with the laws of the State of Florida without regard to principles of conflicts of laws.

If applying for a family membership, the signatures of both parties are required.

Date:   , 20                                         Applicant 

                                                                                             Applicant's Spouse

   
This Membership Agreement shall not be binding on the Club until the acceptance below is signed.
    APPROVED AND ACCEPTED:
    THE NEW INDIAN RIVER CLUB
d/b/a/ INDIAN RIVER CLUB
  By:                           Date:
Name:
Title:   Director
Comments:   
     
Membership privileges will not commence without written consent of receipt of “The New Indian River Club Summer Member Rules and Regulations” by the Summer Membership Applicant.

 


Indian River Club ~ 800 Carolina Circle SW ~ Vero Beach, FL 32962  ~   Administration 772-770-0757