Name *

First Name

Last Name

Phone *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Skill Level

Beginner

Intermediate

Advanced

Expert

Pro

Are you a current member of The Club at Pine Forest? *

Yes

No

Membership Level *

"The Clay" Single Pickleball Membership ($35 per month; $25 for current members)

"The Clay" Family Pickleball Membership ($55 per month; $45 for current members)

Spouse Name (for Family Membership only)

First Name

Last Name

Auto Draft Information (See Terms and Conditions Below) *

I do hereby authorize Pine Forest County Club, to automatically draft my debit/credit card for my monthly member statement charges. I understand that my account will be drafted for the full amount due on the 10th of each month, or the first business day after the 10th of the month, whichever is earlier.

Yes

No

Today's Date *

MM

DD

YYYY