| Last Name:
_____________________________ |
First Name:
_____________________________ |
| Age:
__________ |
Birth Date:
_____________ |
| Additional
Family Member's Name:
________________________________________ |
| Age:
__________ |
Birth Date:
_____________ |
| Additional
Family Member's Name:
________________________________________ |
| Age:
__________ |
Birth Date:
_____________ |
| Address:
___________________________________________________________________________ |
| City:
______________
State: ___________ |
Zip:
____________________ |
| Phone Number: (____)
_________________ |
|
|
| (Please
Check) |
|
| Season Pass -
Single__________ Additional Family
Member_________ One Additional
Family________ |
| Senior Pass -
Single__________ Additional Family
Member_________ |
| Bargain
Individual___________ Additional
Family Member_________ |
| Student
Pass________________ |
|
| TOTAL AMOUNT
ENCLOSED $_______________________________ |
| Payment Method
(Please Check): Cash_________ Check_________ Credit
Card_________ |
| |
| Signature:
__________________________________________________ |
| |
| If paying by
Credit Card, please provide the following
information. |
| Name as it
appears on the card:
________________________________________________ |
| Credit Card
Number: ___________________________________
Expiration Date: ______________________ |
| Please
Circle: VISA or
MASTERCARD |
| |
Make Check payable to Whetstone Golf Club.
Mail
Registration and Payment to: |
Whetstone Golf Club
5211 Marion Mt. Gilead
Rd.
Caledonia, OH 43314 |
| |
|
| If you have any questions, please contact Clarence Perry at
(740) 389-4343. Weather permitting, the pro shop
may be open on various days, in which you can pay for your pass,
otherwise please mail. |