Primary Applicant

First Name *

Last Name *

Title

Nickname

Date of birth *

Email *

Primary Phone (mobile) *

Address *

City *

State *

Postal code *

College(s) Degree with Dates

Place of Employment

Hobbies & Special Interest

Golf Handicap (if applicable)

Referred by

Applicant's Spouse

Spouse Last Name

Spouse First Name

Spouse Title

Spouse Nickname

Spouse Birthday

Spouse Email

Spouse Phone Primary

Spouse Phone Secondary

Want to receive Club Emails?

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Yes
No
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Anniversary Date

College(s) with Degree & Dates

Place of Employment

Hobbies & Special Interests

Spouse Golf Handicap (if applicable)

Children

(Unmarried children under the age of 21, or to 25 should the child be attending college, qualify for immediate family privileges.)

Child 1 Full Name

Child 1 Date of Birth

Child 2 Full Name

Child 2 Date of Birth

Child 3 Full Name

Child 3 Date of Birth

Child 4 Full Name

Child 4 Date of Birth

Child 5 Full Name

Child 5 Date of Birth

Child 6 Full Name

Child 6 Date of Birth

Membership Details

Membership Type *

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Social Membership (all ages)
Standard Full Membership (ages 36-64)
Junior I Full Membership (ages 21-29)
Junior II Full Membership (ages 30-35)
Senior Full Membership (ages 65-75)
Super Senior Full Membership (ages 76+)
Non-Resident Full Membership (reside outside of Cullman County)
Out of State Full Membership (reside outside of Alabama)
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Optional Services

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Club Storage
Locker
Range Plan
Handicap Fee
Hole in One Club
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TP Resident w/ Private Cart

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No
Yes
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Email Address for Billing Statement *

Initiation Fee

Select TPCC Initiation Fee *

TPCC Initiation Fee

Terri Pines Country Club Membership One-Time Initiation Fee

$250

*100% secure & safe payments*

Upon acceptance of Membership, I, the applicant, agree to follow all Terri Pines Country Club bylaws, rules, and regulations as set forth by the Club. I grant Terri Pines Country Club ('Photographer") permission to use, reuse, publish, and republish (includes for promotional material and Club social media/website) any photographs that have been taken or may be taken of me or in which I may be included with others.

I also authorize the Club to charge my credit/debit card for my monthly balance on the 5th of each month. I further agree to agree to provide the Club with an updated credit/debit card as requested. I will inform the Club of all address, phone number, and email changes to keep the Club files current.

*Note: The member and spouse hold the membership with surviving rights. Should one party become deceased, the other party is entitled to continue the membership without payment of an additional initiation fee.

I agree to terms & conditions provided by the Terri Pines Country Club. By providing my email and phone number, I agree to receive email and text messages from Terri Pines Country Club.