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