PAGE 1 SOMERSET SINGLES SOCIAL SKI AND GOLF CLUB ONLINE NEW MEMBER APPLICATION *Form is invalid without a SIGNATURE and DATE* Instructions: Please fill out the form. Print Member Application form page two (2). Then print Responsibilities form page three (3) on the back. SIGN AND DATE 1: Annual dues are $40.00 from date of application. Fill in all requested information, read the policy on the reverse side, sign and date. Make check payable to SSS&GC and mail with this completed form to: Pat Miller 8401 18 Mile 16A, Sterling Heights, MI 48313 H-586-739-6885 2: Or pay $35.00 by printing and filling out this form and bring it to the next Membership Meeting with your check payable to SSSGC. Somerset Singles Hotline 586-307-3930 PAGE 2 SOMERSET SINGLES SOCIAL, SKI & GOLF CLUB NEW MEMBER APPLICATION Annual dues are $40.00 from application date Fill in all requested information, read the policy on the reverse side, sign and date. Make check payable to SSS&GC and mail with this completed form to: Pat Miller 8401 18 Mile 16A, Sterling Heights, MI 48313 H-586-739-6885 Renewal Month: __________ Referred by: ________________________ Membership Director Only:: ______ Ck No: ______ Cash: ______ Somerset Bucks: ______ Date of Signature: PLEASE PRINT ALL REQUESTED INFORMATION Male ___ Female ___ Update Present Status: Never Married ___ Divorced ___ Widowed ___ Name: ____________________________________________________________________________ Address: _________________________________ City: __________________ State: ____ Zip: _____ Phone No: H-______________________ C-______________________ W-______________________ Birth Date: Month ______ Day _____ Occupation: ___________________________ Retired: ______ E-Mail: ______________________________________________________________________________ Update Activity Interest - Please check all that apply: Biking ___ Boating ___ Bowling ___ Canoeing ___ Cards ___ Cross Country Ski ___ Dancing ___ Downhill Ski ___ Golf ___ Hiking ___ Travel ___ Other activities not mentioned above.______________________________________________________ We can always use your help & ideas. Which committee would you like to help with? Please check. Bowling ___ Charity ___ Entertainment ___ Golf ___ Hospitality ___ Membership ___ Newsletter ___ Ski ___ Social ___ Travel ___ Anywhere I am needed ___ Emergency Contacts: The following information will be in a sealed envelope with a Trip Leader and opened only in case of an emergency situation. Contact Names Relationship Phone Numbers _________________________ __________________ __________________ _________________________ __________________ __________________ Allergies (Optional) ____________________________________________________________ PAGE 3 Read the Responsibilities and Trip Cancellation Policy on the reverse side, sign and date. Form is invalid without a signature. Somerset Singles Social, Ski & Golf Club Responsibilities Golf, skiing, travel, events, meetings and other activities sponsored by the Somerset Singles Social, Ski & Golf Club involve external factors that are beyond the control of the Club and its directors, officers, trip leaders and event coordinators. These external factors could include weather, war, labor disputes, strikes, fire, conditions of equipment including aircraft, vehicles and ski lifts, conditions of terrain including rocks, debris, bare spots, trees, signs and other obstacles, marked or unmarked, conditions of golf courses and action or inaction of governments, transportation entities, resort owners or operators, and skiers, golfers, snowboarders, individuals and other entities. Participation, in any activity, sponsored by the Club is entirely voluntary and each Participant must exercise judgment and care at all times to minimize the risk of inconvenience, injury or death to herself/himself, other members of the Club and all other persons. The Club serves only as the sponsor of activities and the Club and it's directors, officers, trip leaders and event coordinators will not be responsible for or liable for any inconvenience, injury or death that occurs during or as a result of participation in a sponsored activity. Cancellations Any event sponsored by the Club can be cancelled at any time by airlines, ground transportation entities or resort owners or operators. If these entities cancel an event, the Club will exert reasonable efforts to obtain refunds of amounts paid by Participants for the event. Additionally, the Somerset Singles Social, Ski & Golf Club reserves the right to cancel any event at any time for its own reasons. If the Club cancels an event for its own reasons, the Club will refund all amounts received from Participants. Somerset Singles Social, Ski & Golf Club Trip policy is as follows: 1. For trips of five (5) days or longer: A twenty-five (25%) deposit of the total cost of the trip, along with a completed reservation form is needed to secure your spot. Also, a refundable deposit of $100.00 will place you on a waiting list. Accommodations are based on the order of sign up. Trips must be paid in full four (4) weeks prior to departure. 2. For trips less than five (5) days: A deposit along with a completed reservation form is needed to secure your spot. Also, a refundable deposit will place you on a waiting list. Accommodations are based on the order of sign-up. Trips must be paid in full four (4) weeks before departure, or you are subject to replacement and loss of your stated deposit. 3. Non-members will be assessed an additional $40.00 charge for trips. This fee will be waived on Ski trips for anyone who is a member of a club that belongs to the Metropolitan Detroit Ski Council (MDSC). Proper ID will be required. 4. Deposits are non-transferable between individuals. 5. Cancellation of a trip: Any Participant who wishes to cancel from a trip must contact the trip leader with a verbal notification and a written notification. Reservations are Non-Transferable. The trip leader will make every attempt to locate a replacement from a wait list. The wait list will take priority over any substitute. If a Participant cancels and no Waiting List exists, the cancelling person may find a substitute of like-sex for their spot. Whether a substitute or wait list Participant is found, the original Participant will be responsible to pay any expenses incurred as a direct result of their cancellation, even if this amount exceeds the total amount of payments made by the original Participant. 6. Cancellation Fees: For a trip of five (5) days or longer or for a trip of less than five (5) days, any Participant who cancels his or her place on a trip, and the Participant obtains a like-sex replacement not yet attending the trip, or on a wait list, the Participant will be reimbursed their deposit, so long as the club has not incurred any additional expenses. Actual expenses incurred by the Club can include fees charged by airlines, last minute name changes, ground transportation, entities and resort owners and operators, nonrefundable lift tickets and transfers, etc. Late cancellation can result in forfeiture of all amounts paid and/or money owing to the Club for a reservation with some or all of these entities. 7. Refunds for cancellation of a trip will be made within approximately thirty (30) days of trip completion upon review of the Board of Directors. Refunds are NOT automatic. Payments Participants are responsible for making payments according to the payment schedule for the event or trip. If payments are not received in accordance with the schedule, the trip leader or event coordinator may offer the reserved space to others on the wait list. A fee of $25.00 will be charged for any returned check. The Board of Directors must approve any deviation from these provisions. Commitment I accept the provision associated with this application regarding Responsibilities, Cancellations and Payments. Signature __________________________________Date_____________ Revised 06/2010