Membership Application
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Herndon Ladies Golf League
2024 Membership Application
Name: _________________________________________________________________
Street Address: _________________________________________________________
City: __________________________ State:_______ Zip: _______________________
Email: ________________________________________________________________
Home Phone: ____________________ Cell: __________________________________
Birthday (month/day): ___________________________________________________
Emergency Contact: _____________________________________________________
Home Phone: ______________________Cell: ________________________________
With submission of this form, I agree to abide by the Bylaws, Rules and Regulations established by the Herndon Ladies Golf League, Board of Directors, and membership. I further agree to hold the League and its agents, free and harmless from any damage or claims of any nature whatsoever whether it be personal and/or property, loss of time, or any loss arising from the condition of, operation of or in any way connected with the use of the Herndon Centennial Golf Course or any part or associated equipment thereof.
Signature: ___________________________________________ Date: _______________
Please confirm your choice for the 2024 season by selecting the 18 hole division or the 9 hole division:
18 Hole Division ______ 9 Hole Division________
Do you have an established handicap? Yes: _____ No: _____
What is your current USGA Handicap Index? ____________
Where is your handicap maintained? ____________________
GHIN Number: ___________________
Annual Dues: $50.00 Please make check payable to HLGL.
Please send completed form and check to:
Mary Hartley
1356 Park Garden Lane
Reston, VA 20194
Questions? Email: mary.hartley1@verizon.net