Membership Application Form 2026/27

Title

Given Names

Surname

Home Address

Postal Address If different to Home Address

Email Address

Phone (Home)

Mobile

Date of Birth

Occupation

Membership Options Membership Options PLEASE NOTE: There is an additional $49 admin fee for all 7 day and 6 day memberships. 6 Day memberships exclude Saturdays. 7 Day Full Membership $1250* 6 Day Full Membership $1150* 7 Days Aged Concession +65 Membership $1150* 6 Days Aged Concession +65 Membership $1000* Get into Golf (conditions apply) $450 Colt (18-21yrs on 1st July) $450 Junior (up to 17yrs on 1st July) $150 Intermediate 1 (Age 22-25) $850 Intermediate 2 (Age 26-29) $1000

Payment Options Please advise how you will be paying for your membership Please selectCome into the clubBank Transfer (please email remittance to admin@antillpark.com.au)Pay via credit card online (click on payment button after submitting the form)

Are you or have you been a member of another Golf Club? Are you or have you been a member of another Golf Club? Yes No

If YES, which Club?

Golf Link Number

Handicap

Would you like Antill Park to be your home club? Would you like Antill Park to be your home club? Yes No

Have you ever been suspended from a Golf Club? Have you ever been suspended from a Golf Club? Yes No

If YES, please provide details

How did you hear about Antill Park Golf Course and what made you decide to join our club? (Tick 1 or more) How did you hear about Antill Park Golf Course and what made you decide to join our club? (Tick 1 or more) Played here before as a visitor, with a social club, as an opposing pennant player Advertisement Social Media Other

If other please specify

Date

Photo ID Type & No.

CODE OF CONDUCT CODE OF CONDUCT I confirm that I have read and agree to comply with the Code of Conduct. I understand that signing this document is a condition of membership and that failure to sign may result in my membership being declined or not renewed. I agree to the Club's Code of Conduct

PRIVACY STATEMENT PRIVACY STATEMENT The Antill Park Country Golf Club Limited is subject to the provisions of the Privacy Act 1988 and the Privacy and Personal Information Act 1998. The personal information provided by you on this application form and attached documents will be used to process your membership application. It is a requirement of membership that this application form is completed and failure to provide all of the requested information may result in your application being rejected. You have a right to access and correct any of your personal information that the Club holds about you. The Club does not usually disclose your personal information to any other organisation or person unless there is a legal requirement to do so. The Club may disclose your information to third parties that provide services under contract to the Club. These contracts require the third party to keep your personal information confidential and secure. Your personal information may be used by the Club for marketing purposes to improve our services and to provide you with the latest information about those services and any new related services and promotions. I acknowledge that my conduct, including on social media, must reflect respectful and appropriate behaviour, and understand that any misconduct may result in temporary or permanent suspension of my membership. I agree

Signature Declaration: I, the person correctly described above, would like to become a member of the Antill Park Country Golf Club Limited, in accordance with the Constitution and agree to abide by the Rules and By-laws of the Club and have read and understand the Privacy Statement. I understand that I am not able to utilise my own golf cart on the course. SaveClear