Leonard Country Club - 2016 Trail Fees Application

Cart Owner Information:

 

Name(s): ________________________________________________

  

Address: _________________________________________________

 

City: _____________________ State: ______ Zip:  ________________

  

Phone Number: ______________________

 

Email Address______________________________________________

 

2016 Personal Cart Trail Fees:

                Gas Cart - $200.00

                Electric Cart - $225.00

                Additional User - $100.00    ____________________________________

 

Personal Cart Owners Agreement:

Please note that Leonard Country Club is not responsible for any damages or loss of personal property stored in the cart shed.

Your costs include storage & trail fees ONLY!

There is no additional insurance coverage included from Leonard Country Club for any lost or damaged property.

Please make sure to speak with your insurance agent to include these items into your current home-owners policy.

I agree to all of the terms above.

                            Print Name:_____________________________________________

                            Signature:______________________________________________

__________________________________________________________________________________________________________________________________________

 

 Check: (Simply Mail Payment to: Leonard Country Club, 5274 153rd Ave Se, Leonard, ND 58052)

 Credit Card#: ___ ___ ___ ___ - ___ ___ ___ ___ - ___ ___ ___ ___ - ___ ___ ___ ___  (M/C, Visa, Amex, Disc)

 Exp. Date: ___ / ___                   CVV2#: ___ ___ ___ (3 Digit Code on Back Of Card)

 Signature: _____________________________________