
Member Number
___________________________
2700 70th
Street SW, Naples Fl 34105-7220 Card Issued
___________Exp Date ______________
Phone 239.659.1502 Fax 239.659.7047 (Club
Naples Administration Use Only)
www.clubnaples.com
Subscriber: Name
____________________________________________________________________________
Address
_____________________________________________,
___________________________, ____________________
City ST ZIP
Telephone
(Home)_______________________ (Work) _________________________(Cell) __________________________
Email
____________________________________Membership Group Affiliation
___________________________________
(Necessary to receive updates via e-mail)
Method of Payment: Check
_____; Credit Card : AMEX _____ Visa _____ MasterCard _____
Checks to be made out to: Club
Naples
Credit
Card Number
________________________________________________________________________________
Exp Date _____/_____ V-Code
(MC and Visa only) ______ (The 3 digits following the credit card account # on
back of card.)
Above subscription is for
one year from date of issuance of the Club Naples Card which will be
mailed within 10 days of receipt of Subscription Form with payment. DO NOT SEND
CASH. Use a separate Subscription Form
for each person being enrolled as a Club Naples member.
Subscriber affirms that
he/she has read and understands the Terms & Conditions which follow this
Subscription Form, a copy of which will be mailed with the Club Naples
Card. Subscriber, if paying for Club Naples membership with credit card,
authorizes charge against the above listed credit card. Subscriptions paid for
by credit card may be sent by US mail, by email to info@clubnaples.com or by fax to (239) 659 7047. Subscriptions
paid by check must be sent by US mail to Club Naples, 2700 70th
Street SW, Naples FL 34105-7220.
How did you hear about
us? TV _____ Radio _____ Newspaper _____ Internet _____
From Club Naples Member ( by
Name)___________________________________________
From Club
Naples Business Member____________________________________
Other
______________________________
RIGHT OF RECISION
- You may cancel this agreement within 3 days of the date of execution of this
subscription for a full refund of your subscription amount by contacting Club
Naples at (239) 659 1502.
Club Naples Subscription Form