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Membership Amount: $________________
Add 5% Vermont Sales Tax: $________________
Capital Improvement Fee: $10.00
Total Due: $________________
Amount Enclosed: $ _______________
* 50% down qualifies you for the pre-season discounted rate.
* Single parent families (divorced/widowed) deduct $75 off of family membership.
* All memberships are non-refundable and non-transferable
I agree to comply with all the club rules and understand that swimming and tennis can be inherently dangerous and release Cupola Golf Course, Inc. dba Quarry Hill Club of any and all liability arising from injury resulting on or off its premises or activities. Parental or babysitter supervision is required of all children under 12. The club reserves the right to close early on certain days as in the past because of bad weather and/or for special events (dates will be posted). Children 12 and under must join with and adult.
Signature: ____________________________________________ Date: __________________
Application not complete without signature
