Pool 1

Benvenue Country Club

2020 Summer Pool Membership
Saturday, May 23rd – Monday, September 7th

To prevent overcrowding, we are limiting the number of Summer Memberships to 40 sold.
Memberships will be sold on a first come, first serve basis, subject to Board approval.

Amenities and Services

* Outdoor Pool with Diving Board and Water Slide
* Gated Baby Pool
* Abundant Lounge Chairs and Shady Umbrella Tables
* Food and Beverage service with ABC License
* Clean Restrooms with Changing Room and Showers

Beautiful Private Country Club Setting

Fee: $975 Family Membership (Includes Children Age 24 and Under Living at home)
*Sign Up before April 15th and Save $50

For more information, please feel free to contact our business office at 252.443.2141
or visit our Web Page at www.benvenuecountryclub.com

To Register: Please Mail, Fax or Email form with Payment:

Benvenue Country Club

PO Box 7606
Rocky Mount, NC 27804
[email protected] Fax: 252.443.6023

Benvenue Country Club

2020 Summer Pool Membership
Saturday, May 23rd – Monday, September 7th

Membership Information: Please print and complete all area.
Last Name:___________First:__________ Birth Date: ___/___/___
Address: _____________________________________________
City:________________ State:___________ Zip:_____________
Home#: (__) _______ Work#: (___) _______ Cell# (___) _______
Email Address:_________________________________________

Family Members: (If couple or family)
Spouse:__________________________ Birth Date: ___/___/___
Child:___________________________ Birth Date: ___/___/___
Child:___________________________ Birth Date: ___/___/___
Child:___________________________ Birth Date: ___/___/___
Child:___________________________ Birth Date: ___/___/___

Sponsoring Benvenue Country Club Member:__________________ (Completed Form Required)

All applications require a letter of recommendation, from the Sponsoring Member, a signed acknowledgement of the Pool Rules and Polices, and a
valid credit card number for the club’s file. The club will automatically bill your credit card for monthly charges by the 8th of each month. All
Summer Membership dues must be paid with registration. Effective January 1, 2020, pool memberships will be limited to two
seasons.

Type of Payment: _____ Visa _____ MasterCard _____ Discover
____ Check (Registration Only)

Credit Card: # _________________________Exp. Date ___________ CVC Code:________________

Please Print Name of Cardholder: ____________________________ Zip Code of CC:______________

_______________________________________ ________________________
Cardholder Signature Date