2016-2017 Member Application

Harmony Hills Cabana Club, Inc.

P. O. Box 790994 info@harmonyhillscabanaclub.com
San Antonio, TX 78279-0994
(210) 342-5872
Please include this application, along with payment (check made out to HHCC) to the above address. If you have
any questions, please email or call the above membership line. Thank You for your Membership!
***I (we) was referred to the Cabana Club by: _____________________________*** Referral code: __________*

(Please Print Legibly)

Applicant Name: ___________________________________ Birthdate: ___________________________
Drivers License # (D/L #): ______________________________ State, if NOT Texas: _______________
Spouses Name: _____________________________ Birthdate: ________________D/L #:_____________
Address: ________________________________ City: ___________________ Zip Code: ____________
Email Address: ______________________________ (your e-mail address is used only for HHCC business you will
receive updates during the season regarding Opening Day, Holiday Celebrations, Tournaments, Adult Nights, Teen
Nights, Weekly Kids Club Activities, GHHA news, etc.)
Telephone #s: Home:__________________ Work: _________________ Cell: ________________
Members in Your Household:
Name if applicable, Relationship Sex Age Birthdate D/L#
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Emergency Contact: __________________________________ Relationship: _______________________

Telephone #s: Home: ______________________ Work __________________ Cell _________________
NOTE: ON THE BACK OF THIS FORM, PLEASE PROVIDE ANY MEDICAL ALERT INFORMATION!

Annual Membership Dues

3 or more Person Household $360

2 Person Household $295
Single Person Household $195

Please circle the above amounts that apply to your household.

We accept: cashiers check, check, online square link or cash.

I agree to abide by all Harmony Hills Cabana Club Rules and Regulations, a copy of which will be provided to me.

___________________________________________________ ________________ Paid in Full Amount: $____________

Signature Date