Club Membership Registration Form

PCLGA 2023 New Member Application
Please complete the application ONLINE. Check your type of membership, the fee and after processing your payment by check, click SUBMIT to send your form... at the end .

Questions re: handicapping: Contact Kathi Curtis 360-907-1555 or kcladygolfer@gmail.com
1. To be a member of the PebbleCreek Ladies' Golf Association (PCLGA), you must be a PebbleCreek homeowner or a renter within PebbleCreek.
2. To participate in Tuesday Play Days or PCLGA tournaments, you must (a) be a Regular Member in good standing, and (b) have an established handicap at PebbleCreek.
3. Applicants must (a) provide records from previous club, including scoring and handicap information and USGA course rating and slope, or (b) provide five(5) recent scores to establish a handicap. (please indicate which tees were used, i.e. red, mixed, white Please submit this information to Kathi Curtis, PCLGA Handicap Chair, via email at:
kcladygolfer@gmail.com
Today's Date*

MonthDayYear
Name (Please enter your First name, Middle Initial and Last Name)*

First NameMiddle InitialLast Name
Residence status: choose one*

HomeownerRenting within PebbleCreek
Homeowner card ID number or Rental card ID number*
If you have not established a handicap see #3 above, otherwise fill in info below.
Do you have an established 18 hole handicap*

YesNo
Comments about your handicap
GHIN #
Other Handicap provider
E-mail*
Goodyear Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Provide cell carrier if you wish to receive last min. updates by text instead of email
Click on Provider
This is optional
Best Phone Number to be used:*

Area CodePhone Number
Click on type of phone *

Home phoneCell phone
Choose A Membership Type
Select 1 Membership Type -- Click on one type to receive all information*

Regular Membership - Full Access & Benefits to the Ladies 18 Hole Association (PCLGA)Associate Membership - For Keeping a handicap ONLY
Regular Membership Fees

Valid Thru 12/31/22
Membership Fees + Name Tag Fee ($6)

Sign up BETWEEN 1/1/23-6/30/23 (PCLGA dues = $36 + AGA dues = $45): $81Sign up BETWEEN 7/1/23-9/30/23 (PCLGA dues = $26 + AGA dues = $25): $51Sign up BETWEEN 10/1/23-12/31/23 (PCLGA dues = $46 + AGA dues = $40): $86 (Please note the 10/1/23 - 12/31/23 amount is good for the remainder of 2023 and all of 2024)
Full name on name tag (cost included in membership)*
Optional Fees

(Check any/all that apply)
Central Arizona Golf District CAGD affords members an opportunity to meet and compete with other women in CAGD golf tournaments. In addition, there are 5 inter-district "blind-draw" days each year where a member's score is combined with another CAGD member to win payout. Plus members support 4 charities for young golfers.

$8 (1/1/23 - 12/31/23)
Central Arizona Golf District CAGD affords members an opportunity to meet and compete with other women in CAGD golf tournaments. In addition, there are 5 inter-district "blind-draw" days each year where a member's score is combined with another CAGD member to win payout. Plus members support 4 charities for young golfers.

$8 (1/1/24 - 12/31/24)
Hole-in-One Insurance Fund. If a member of a Hole-in-One Fund scores a witnessed hole-in-one at PebbleCreek, she will be paid $100 from the fund.

$5 (1/1/23 - 12/31/23)
Hole-in-One Insurance for 2024

$5 (1/1/24 - 12/31/24)
Associate Membership

For keeping a handicap ONLY
Associate Membership Sign Up Dates

Sign up BETWEEN 1/1/23-6/30/23(PCLGA dues = $5 + AGA dues = $45): $50Sign up BETWEEN 7/1/23-9/30/23 (PCLGA dues = $5 + AGA dues = $25): $30Sign up BETWEEN 10/1/23-12/31/23 (PCLGA dues = $5 + AGA dues = $40): $45 (Please note the 10/1/23 - 12/31/23 amount is good for the remainder of 2023 and all of 2024)
Questions regarding dues, contact Denise Johnson denisejohpclga@gmail.com 775-443-6460
Amount Due: Total of all dues and optional fees
Total Due if paid by Paypal*
Total Due if paid by Check*
Payment method ---Please click on one*

PaypalCheck
Amount To Be Paid via Paypal

prevnext( X )
USDDescription
Total Due $
Please write a check payable to 'PCLGA'

and mail it to the Treasurer, Denise Johnson, at

16705 W Alvarado Drive, Goodyear, AZ 85395
Should be Empty:

Now create your own Jotform - It's free!Create your own Jotform

PCLGA 2023 New Member Application

Choose A Membership Type

Regular Membership Fees

Optional Fees

Associate Membership

Amount Due: Total of all dues and optional fees