2010 Membership Application Form

Name    ________________________________________________________________________

Address    ______________________________________________________________________

City    ____________________________________ State    _______________    Zip___________

Date of Birth: _____/______/___________ Cell phone:__________________Home:___________

E-mail:_________________________________________________________________________

Date or Application    __________________

                                                                        "Please Check One"
                                                Renewal    ________    New Member    _________

Renewal - $5 / New Member - $10 / Full Time Students Membership Fee is $5

Please make checks payable to:         Columbia Disc Golf Club
and send to:                                       c/o David Sauls
                                                         4064 Beltline Blvd.
                                                          Columbia, SC 29204