PGA NATIONAL MEMBERS CLUB MEMBERSHIP APPLICATION

PGA NATIONAL MEMBERS CLUB MEMBERSHIP APPLICATION CANDIDATE INFORMATION Mr. Mrs. Ms. Dr. Primary Candidate Today s Date / / Home Address Date of Birth / / City State Zip Home Phone Cell Phone Local Phone Local Address City State Zip Marital Status Single Married Wedding Anniversary Date Social Security # (last 4 digits) Driver s License # (Copy to be provided at time of application) Business Name Type of Business State Title Length of Employment (yrs) Business Phone Business Address City State Zip Business E-mail Personal e-mail Send Club Emails to this address Mr. Mrs. Ms. Dr. Spouse/Spousal Equivalent/Significant Other Date of Birth / / Social Security # (last 4 digits) Driver s License # State Home Phone Business Phone Cell Phone Business Name Type of Business Title Length of Employment (yrs) Personal e-mail Send Club Emails to this address List unmarried children under the age of 23 who reside at home: Yes I/we have dependents as indicated below. No I/we do not have dependents residing with us. Name(s) Date of Birth Interests Charge Privileges / / Golf Tennis Yes No / / Golf Tennis Yes No / / Golf Tennis Yes No Online Club Directory: Please indicate whether you would like to be listed in the Online Club Directory, and which address and phone is to be listed: Yes No Address: Home Address Local Address Phone: Home Phone Cell Phone INTERESTS: Check all that apply PLEASE BILL ME FOR: Check all that apply Men s Golf Association Men s Tennis ************************* Men s Golf Locker Ladies Golf Association Ladies Tennis ************************* Ladies Golf Locker Handicap Services Ladies Cards ************************* Men s Club Storage Fitness Center Men s Cards ************************* Ladies Club Storage

MEMBERSHIP INFORMATION: I am/we are applying for Membership in the following Category: FAMILY INDIVIDUAL Total Joining Cost : Non-Refundable Portion** $ (+ tax) + Refundable Portion**: $ Current Annual Dues**: $ (+ tax) Dues Prorated through October 31 st : $ (+tax) **The combined total of the Non-Refundable Portion and Refundable Portion written above is the TOTAL actual amount paid by Member (or if paying in installments, the total amount required to be paid by Member in accordance with the terms of Member s promissory note or installment payment agreement). Applicable sales tax, if any, not included. PALMER ADVANTAGE PLATINUM [Please initial YES or NO] Current Monthly Upgrade Palmer Advantage Platinum Dues** $ YES, please enroll me/us in the Palmer Advantage Platinum benefit. With my enrollment, I/We agree to be bound by the terms and conditions of the benefits available at www.palmeradvantage.com, I/We understand that I/we will be subject to payment of additional monthly dues in exchange for the Palmer Advantage Platinum benefit, which may be increased from time to time. I/We also agree to pay any charges I/we incur at the participating clubs. I/We further agree to conform to and be bound by the Bylaws and Rules and Regulations of the participating clubs, all of which may be amended or modified from time to time. NO, I/we am/are not interested in participating in upgraded Palmer Advantage Platinum benefits at this time. PGA NATIONAL MEMBERS CLUB SPONSOR (PREFERRED) NAME PHONE # EMAIL ADDRESS PERSONAL REFERENCES NAME PHONE # EMAIL ADDRESS OTHER CLUB MEMERSHIPS CLUB NAME CITY STATE PAYMENT OF MEMBERSHIP ACCOUNT I/We would prefer monthly statements to be mailed to: Home Business e-mail Payment of Membership Account, including all dues, fees and other applicable charges, is due upon receipt of the monthly statement. If accepted for membership, I/we agree to pay the account in full when due. I/We agree and understand that a late charge up to the maximum amount allowable by law, or other penalties, may be assessed for past-due accounts as provided for in the Bylaws and/or Rules and Regulations of the Club, as amended from time to time. In addition to late fees, penalties may include, but are not limited to suspension of Club privileges and/or expulsion from membership. I/we agree to maintain a valid major credit card on file with the Club at all times. In the event that my/or account becomes more than ninety (90) days past due, Club is hereby authorized to bill the card number on file. Payments on delinquent accounts shall be applied first to reduce late charges, then to reduce accrued dues and food & beverage charges (with the payment applied to reduce the oldest past due balances first), and then to any other charges. Any fees assessed for untimely payment of any applicable dues, fees or charges will appear on my/our statement. I/We agree to pay all reasonable attorneys' fees, investigator fees, and costs in the event this account is turned over for collection.

MEMBERSHIP POLICIES If accepted into membership, I/we agree to conform to and be bound by the enrollment terms contained herein, the Bylaws, the Rules and Regulations, and written membership policies of the Club ( Membership Documents ) as they may be amended from time to time. I/We further understand that agreeing to be bound by the Membership Documents is a part of my/our agreement for membership privileges with the Club. I/We specifically understand this membership is not divisible. I/We hereby acknowledge receipt of a copy of the Bylaws and/or the Rules and Regulations of the Club. I/WE ACKNOWLEDGE THE MEMBERSHIP BYLAWS AND THE RULES AND REGULATIONS PROVIDE THE DETAILS OF THE CLUB S MEMBERSHIP POLICIES, CONDUCT AND OBLIGATIONS, INCLUDING, BUT NOT LIMITED TO, PROVISIONS IN THE EVENT OF DIVORCE, FOR ARBITRATION OF DISPUTES, RESIGNATION, REDEMPTION OF MEMBERSHIPS, FINANCIAL OBLIGATIONS, DISCIPLINARY ACTION, RELEASE OF LIABILITY FOR PERSONAL INJURY AND THEFT. I/WE HEREBY FULLY RELEASE AND DISCHARGE THE CLUB, ITS EMPLOYEES, AGENTS, SHAREHOLDERS, MEMBERS, MANAGERS, AFFILIATES AND ASSIGNS FROM ANY LIABILITY, INJURY, LOSS, DAMAGE OR CLAIM ARISING FROM MY/OUR USE OF THE CLUB FACILITIES. I hereby acknowledge receipt of the Membership Plan and agree to be bound by the terms and conditions thereof as the same may be amended from time to time by the Club in its discretion. I also understand that membership is on a nonproprietary basis. I understand that membership may be terminated by the Club, in its sole discretion, for failure to abide by membership conditions as set forth herein and in the Rules and Regulations. I hereby acknowledge that I have reviewed the Rules and Regulations of the Club, specifically the following Sections of the Rules and Regulations regarding my membership rights: Article A Section 2 Charter Membership Rights Article A Section 15 Suspensions and Termination of Membership Article A Section 16 Loss or Destruction of Property Article A Section 20 Acknowledgement of Membership Rights By providing the address(es) (including e-mail), phone numbers(s), and fax number(s) above, I/we hereby give the Club my/our express written permission to contact me/us at each number or address in accordance with the terms and conditions of the Club s Privacy Policy, a copy of which is available on the Club s website. I/We acknowledge that the Club values my/our right to privacy. I/We understand that I/we can revoke this consent at any time by contacting the Club in writing. I/We agree the terms and conditions of my/our membership may not be added to, amended, or contradicted in any way by evidence of prior, contemporaneous, or subsequent oral agreements of any kind and acknowledge there are no unwritten oral agreements of any kind. By signing below, we hereby certify that we hold a marriage license, or a certificate of domestic partnership or civil union, which evidences our existing spousal relationship. If we do not hold one of the above, we acknowledge that the Club requires execution of a separate Spousal Relationship Statement. By signing the below, I also hereby agree and consent to allow representatives of the Club to photograph, film, tape and/or record my likeness, voice, sound and quotations. I hereby grant to the Club and all related and affiliated entities, and their respective licensees and assigns, and the directors, officers, employees and agents of each (collectively "Released Parties"), forever and throughout the world, the right to use and license the right to reuse such photographs, films, tapes and/or recordings of my likeness, voice, sound, quotations, and my name, in all media, whether now known or hereafter devised, throughout the universe in perpetuity, whether for advertising, publicity, or promotional purposes or for any other purposes whatsoever. I/We authorize Club to check my/our credit and employment history and to obtain such information as Club deems necessary to accept my/our application and to extend credit to me/us under my/our membership account at the Club. I/we understand and agree that 30-day written notification sent via certified mail, or e-mail to the General Manager or Membership Director is required for resignation from the Club, and I/we further agree that all charges, dues, and/or fees incurred during the 30-day period are valid debts. Primary Candidate s Signature Date Spouse/Significant Other/Spousal Equivalent s Signature Date For Office Use Only: Name of Ambassador Assigned to New Member: Source of New Member (from ACT):

PGA NATIONAL MEMBERS CLUB DRESS CODE POLICY The Dress Code Policy at PGA National Members Club has been established to preserve the club s ambience as a respectable, family-oriented destination for intimate dinners, business functions and family gatherings. The Committee wants all Members to feel comfortable and proud of their club. Appropriate Country Club Casual Attire: Club appropriate blue or colored denim/blue jeans are permitted in all areas of the Members Club. The host of a private event will determine if their guests may wear blue denim/blue jeans. Club appropriate denim is defined as blue jean pants that are not torn, frayed, dirty or ill fitting. To be clear: not too tight, too loose, in disrepair or adorned with words or pictures that may be offensive to others. Golf, Croquet and Tennis athletic attire. Shorts, slacks, trousers, collared shirts or banded collared shirts for men. Jackets for gentlemen are optional with exception of special events. Events requiring jackets will be advertised as such. Shoes, sneakers, golf shoes. Appropriate blouses/tops or dresses are required for ladies. Sundresses/or blouses with spaghetti straps are permitted, (cover ups are requested), provided that the attire is in good taste and respectful of the Club and its Members. Unacceptable Attire: Cotton/Athletic Style T-shirts. Cutoffs, ripped or torn parts on clothes. T-shirts with logos. Sweat suits/bathing suits/swimming trunks. Pool and beach footwear is not permitted. NO BEACH FLIP FLOPS. Spandex or Lycra - such as biker shorts. Midriff length tops - mid sections must be covered. Hats/visors are not permitted for men indoors. Tank tops for men. In all areas, for all ages and both genders, excessively tight, short or baggy clothing is not considered appropriate Country Club attire. Cell Phones: Cell Phones MUST be PLACED ON SILENT or VIBRATE. NO cell phone conversations are permitted in the Club Bar & Grille. Smoking: The screened-in patio off the Member s Club Lounge and banquet room is a NO SMOKING area due to Florida law. Smoking will be permitted downstairs outside of the front or side doors of the Club House. Compliance: In order to safeguard the comfort of other Members and guests, dress code noncompliance can result in refusal of admittance or service at the discretion of management on duty. Review and Revision: Management along with the House and Events Committee and Board of Governors reserve the right to rescind and/or amend this and all policies at any time.

Questions: Questions or concerns regarding the Club s dress code may be directed to the Manager on duty or the House & Events Committee Chairperson. Golf Course Attire The following items are NOT permitted on the course or at practice facilities: Denim of any color, tee shirts, tank tops, swimming attire, halter tops, running shorts, gym attire, short shorts, cargo shorts, worn or tattered clothing. This is not acceptable golf attire. I/We have been informed about the Dress Code. Signature: date:

MEMBERS CLUB PGA NATIONAL RESORT & SPA CREDIT CARD AUTHORIZATION FORM CREDIT CARD INFORMATION I hereby designate the following: Visa MasterCard Amex Discover to be used by me and my authorized family members for fees and charges at PGA National. The Club may bill such fees and charges directly to me on this credit card account. I understand that a copy of the vouchers will be kept on file if I should have any questions concerning a charge made to my account. If accepted for membership, I/we agree to pay the account in full when due. I/We agree and understand that a late charge up to the maximum amount allowable by law, or other penalties, may be assessed for past-due accounts as provided for in the Bylaws and/or Rules and Regulations of the Club, as amended from time to time. In addition to late fees, penalties may include, but are not limited to suspension of Club privileges and/or expulsion from membership. I/we agree to maintain a valid major credit card on file with the Club at all times. Any fees assessed for untimely payment of any applicable dues, fees or charges will appear on my/our statement. I/We agree to pay all reasonable attorneys' fees, investigator fees, and costs in the event this account is turned over for collection. PLEASE PRINT: Name as it appears on card Billing Address City State Zip Designated Credit Card Number Expiration Date Authorization Code (Back of Card) Member Signature Date Please use this credit card to auto bill my house charges monthly. Please bill my enrollment fees to this card