GLASS HILL GOLF CLUB, INC.

P.O. BOX 28  DOVER RD.

BARNEVELD, NY  13304

glasshillgolf.com

Trail Fee Application

I hereby agree to proper use and procedure of carts on the course at Glass Hill.  I acknowledge the undersigned person(s) will be the only users (drivers) of said cart.  I have enclosed $150.00 for my trail fees in addition to my regular membership fees.

Please print names clearly on lines below:

1.__________________________________________

2.__________________________________________

Cart Number_____________________ 

Signed:_________________________________________

Date:___________________________________________