2010-2011 KWRC Membership Application/Renewal

September 1, 2010 – Welcome back existing members and welcome aboard new members! The
board is happy to announce membership dues remain unchanged for 2010-2011 however dues
are now subject to HST. AC Units for the doubles court, front house lounge and change rooms
have been replaced over the summer. Additionally the club welcomes the addition of a second
Division 3 Doubles team into the OSDL. Please return fill out the form below and return by mail or
dropped off under the kitchen door at the club by September 15th.

Yours in health, happiness and squash!

Kitchener-Waterloo Racquet Club Board of Directors

2009-2010 Membership Dues

Sr Int. II Int. I Jr./Student Out of Town Social Fitness Softball Only1
2
Annual $951.57 $637.34 $445.24 $276.15 $457.80 $84.38 $333.33 $500.00
HST $123.70 $82.85 $57.88 $35.90 $59.51 $10.97 $43.33 $65.00
Total $1075.27 $720.19 $503.12 $312.05 $517.31 $95.35 $376.66 $565.00
Monthly $83.26 $55.77 $38.96 $24.16 $40.05 $7.38 $29.17 $43.75
HST $10.82 $7.25 $5.06 $3.14 $5.21 $0.96 $3.79 $5.69
Total $94.08 $63.02 $44.02 $27.30 $45.26 $8.34 $32.96 $49.44

Member Information
Existing members, please provide all information so we can make sure our records are accurate.
Name: Birth date: MM-DD-YYYY
Address: Phone (H):
City: Phone (W):
Postal code: Province: Email:

Credit Card Information

We require a credit card on file for billing of your bar purchases, pro shop purchases, league and tournament fees.
Visa MasterCard Number: CVV : Expiry : MM-YYYY

Membership Category: Payment option:

Senior Ages 31 and over Annual payment. Please provide cheque payable to
Intermediate II Ages 26-303 “Kitchener-Waterloo Racquet Club” by September
15th
Intermediate I Ages 21-253
Junior/Student Ages 21 and under3 Annual payment using my credit card info above4
Out of town Monthly preauthorized payment2. Please provide a
Social voided cheque
Fitness
Softball Only

1
Softball Only members are entitled to full use of the softball and fitness facilities but no booking privileges for doubles
2
Please note a 5% discount is given to those who pay annually in September, already included in the price shown
3
Please attach a photocopy of your birth certificate or drivers license for proof of age.
4
Please note a 3% service fee applies to membership payments by credit card.

Kitchener-Waterloo Racquet Club (519) 745-6108 HST # 10522 2970 RT0001

138 Duke St. East, Kitchener, ON, N2H 1A7 treasurer@kwracquetclub.com www.kwracquetclub.com