MEMBERSHIPCONVERSIONFORM
[HeritageNetworkPlusBenefits]
MembershipName: MembershipNumber:
MEMBERSHIPCLASSIFICATION&DUESRATE
I/We hereby request that my/our Golf Membership be converted to include PLUS benefits. I/We understand that the currentannualduesrate is$_________________andthatsuchannualduesrate maybesubjecttocustomaryincreases. I/We further understand that the annual dues are billed on April 1st of each year and will be billed and payable upon receipt each April 1st unless I/we inform the club on or before March 1st of each year. The annual dues will be proratedfornewMembersonaquarterlybasisonly.
TRAVELPLUSBENEFITS
I/We acknowledge that participation in travel benefits is included in my/our PLUS benefits. I/We understand that the current upgrade/enrollment fee of $_________________ to acquire PLUS benefits has been waived during this introductory promotion period, and annual dues for participation in Travel benefits are included in my/our total annual dues, which shall be subject to increase from time to time. I/We also agree to pay any charges I/we incur at the participating club(s) at time of purchase to that club directly. I/We further agree to conform to and be bound by the MembershipBylawsandRulesandRegulationsoftheparticipatingclubsaswellasthetermsandconditionspertaining toTravelbenefits,allofwhichmaybeamendedormodifiedfromtimetotime.
By signing below, I/we acknowledge that I/we understand and agree to all of the terms and conditions referenced herein and that I/we agree to be bound by the Membership Bylaws, Rules and Regulations and other policies and procedures of my home club as well as any other club to which I may have access in connection with my membership and/or PLUS benefits. If I am signing below as a spouse or spousal equivalent, I understand that I am jointly and severally liable for payment of all charges, dues and fees incurred under the membership account after the date of this conversionform,andIagreetopaytheamountinfullwhendue.
PrimaryMember’sSignature Date
SignatureofSpouse/SpousalEquivalent(ifapplicable)
November2022
Date