Eagle Canyon Golf & Lifestyle Estate

Name
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Required
Title Required First Required Last
Email *
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Phone *
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ID Number *
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Required for handicapping purposes
Date of Birth *
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dd-MM-yyyy
Address
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Required
Street Address
Address Line 2 Required City Required County Required
Postal Code

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Country
Membership Subscription *
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Do you wish to have a full playing card (Unlimited Golf) *
N/A

Yes
No
Would you like to purchase rounds upfront?
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No Thanks
Yes, 30 Rounds
20 Rounds
10 Rounds
Would you like any of the following Add-Ons?
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Would you like to pay the amount upfront or prefer to do a Debit Order?
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Debit Order Details
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Beneficiary Name

Account Holder

Bank Name & Branch

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- Beneficiary Name
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- Account Holder *
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- Bank Name & Branch *
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- Account Number *
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- Account Type *
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- N/A
  
  I hereby authorise Eagle Canyon Golf Club to debit the above mentioned account as per the governing terms of Eagle Canyon Golf Club * I hereby authorise Eagle Canyon Golf Club to debit the above mentioned account as per the governing terms of Eagle Canyon Golf Club Required
Please note that we will not initiate a Debit Order unless authorised.
Emergency Contact Name *
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Emergency Contact Number *
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Are you a current- or past member of another Club *
N/A

Select "Not applicable" if you were not a member of another club before joining Eagle Canyon Golf Club
If current or past member, which club?
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If current member, do you wish to transfer your handicap to Eagle Canyon Golf Club?
N/A
Do you have a family member that is currently a member of the Golf Club? *
N/A
If yes, please state their name and relation to you *
N/A
Signature *
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E-Signature Field
Clear

I hereby agree to abide by the rules and regulations set out by the Constitution of Eagle Canyon Golf Club and the terms and conditions provided (see T's & C's below)
Privacy Policy
*
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You hereby give permission for Eagle Canyon Golf Club to communicate to you on all Club related matters via email or sms
Indemnity Clause *
N/A

I hereby apply for membership at Eagle Canyon Country Club, and if elected, I agree to abide by the terms of the Constitution, the Rules and Byelaws.

I acknowledge and agree that the Club shall in no circumstances whatsoever be liable for any loss of or damage to the property of any members or guests brought onto the premises of the Club whether occasioned by theft or otherwise, nor shall the Club be held responsible or in any way liable for personal injury or harm however caused to members or their children or their guests on the Club premises.

I agree to the Indemnity Clause
N/A

Terms and Conditions
*
Terms and Conditions
Required

Click to re-direct to booking and membership terms and conditions
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Club Governance
*
Club Governance
Required

Click to re-direct to Club Governance document
Feel free to view our Local Rules at the Club
Date Completed
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dd-MM-yyyy HH:MM AM/PM

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Eagle Canyon Golf & Lifestyle Estate - Application Form

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