New Member Application

Your are just moments away from giving your family the best summer gift ever! Please fill out the following application form. Once you have completed the application, you will receive a confirmation email from info@brookhillclub.com, so make sure to allow email from this address if you have a spam blocker active.

Membership Information

Standard Family
This membership is for families of 3 or more.
$520
     
Standard Adult/Couple
Entitles a single parent with 1 child, single adult, or adult couple (member and spouse) to use the pool and facilities.
$315
     
Senior Membership (55 years or older)
Entitles a couple (member and spouse) to use the pool and facilities. Member OR spouse must meet the age requirement.
$290

Primary Member Information

First Name:

Last Name:

Date of Birth:
mm/dd/yyyy

Email:

Email (confirm):

I do not have access to email and/or I prefer to receive communications via mail

Home Address:

Zip Code:

Home Phone:
xxx-xxx-xxxx

Business Name:

Position:

Business Phone:
xxx-xxx-xxxx

Spouse's Information

Have a spouse? If checked, spouse info will be required.

First Name:

Last Name:

Date of Birth:
mm/dd/yyyy

Business Name:

Position:

Business Phone:
xxx-xxx-xxxx

Children

#1 Name: Birth Date: mm/dd/yyyy
#2 Name: Birth Date: mm/dd/yyyy
#3 Name: Birth Date: mm/dd/yyyy


Policy and Payment

Estimated Total Dues:

* A $100 deposit is required to secure your place on the wait list. Wait list applicants are seleted in the order deposits are received.

Membership Application Agreement

I hereby apply for a membership to Brookhill Country Club, for which I agree to pay the selected annual dues. This entitles me to a one year Membership. Dues must be paid annually to keep my membership in effect. Failure to pay annual dues by May 15th each year will terminate my membership. If accepted as a member in the Brookhill Country Club, I agree to abide by all the rules, regulations, and by-laws now in existence or which may, here-after be amended by the Board of Directors.

Alcohol Agreement

I understand that it is against Nebraska state law and Brookhill CC policy to bring outside alcohol to Brookhill CC. I understand that if I or any guest I bring break this rule my membership privileges may be revoked.

Media Consent

I and all persons listed on my membership hereby consent to the taking of photographs by Brookhill. I also grant the right to use said products for non-profit use and promotion. I also hereby release Brookhill CC and its employees from all claims, demands, and liabilities whatsoever in connection with the above. I understand that no personal information, such as names, will be used in any publications unless express consent is given.
I have read and agree to the member application policy.
I've been given and reviewed the Membership Packet
I agree to the rules outlined in the above packet