IMPORTANT NOTICE FOR 2021 MEMBERSHIP APPLICATIONS
SEE HIGHLIGHTED AREA ON NEXT PAGE
PLEASE CHECK TYPE OF GOLF MEMBERSHIP DESIRED
(All Golfing Privileges are Non-Transferable)
Applicant must be an Orange County Resident
$1,500 ea. ALL INCLUSIVE MEMBER. No daily green fees, does not include carts.
ALL INCLUSIVE MEMBER for spouse or child
$750 ea. 18 years and under of ALL INCLUSIVE MEMBER
holder above. No daily green fees, does not include carts.
Name: ______________________ Name:_____________________
$0 VETERAN MEMBER:
This membership gives the holder a $5 discount from opening to 12:59pm and $3 discount from
1:00pm to closing. Proper documentation required: Orange County Veterans Discount Card or
Veterans Administration ID Card.
$50 ea. SENIOR CITIZEN MEMBER:
This membership gives the holder a $5 discount from opening to 12:59pm and $3 discount from
1:00pm to closing. Holder must be 65 years old or older to qualify.
$50 ea. REGULAR MEMBER:
This membership gives the holder a $2 discount from opening to 12:59pm and $1 discount from
1:00pm to closing.
I hereby represent that I am a qualified applicant for an annual golf membership for use of the Stony Ford and/or
Hickory Hill Golf Courses, by reason of being a bonafide resident of the County of Orange.
Any misrepresentation shall be grounds for: (a) revoking the golf membership of the undersigned; (b) loss of
any right to refund of the fee paid for annual golf membership or other facilities of the golf course: and (c) for
prosecution under applicable laws of the State of New York. I agree to abide by all the rules and regulations governing
the operation of the golf course. The above statements as to qualifications are truthful.
This is to certify that the undersigned has received and examined a set of rules and regulations prepared for
golfing privilege holders of the golf courses and accepts the terms, conditions, rights and limitations set forth therein and
reservation expressed therein authorizing the Orange County Department of Parks, Recreation and Conservation,
hereinafter referred to as OCDPR & C., to make such additions and modifications by written rules and regulations as the
Department might determine to be necessary for the management and operation of the golf course and the undersigned
acknowledges that the County of Orange is not bound or obligated by any other statement, oral or written, by any
official, employee, or person, all rights to the use of the golf course being limited to the provisions set forth in the
official rules and regulations of the OCDPR & C. Applications subject to approval by OCDPR & C. and may be limited
as conditions warrant. All rates are subject to revision.
Application Page 1 of 2
All Inclusive Memberships do not apply to Golf Outings, Tournaments & Special Events
EventsEventsEvents
Membership discounts do not apply to Golf Outings, Leagues, Tournaments and Special Events
2021 STONY FORD / HICKORY HILL
GOLF MEMBERSHIP APPLICATION
Orange County Department of Parks, Recreation & Conservation
Steven M. Neuhaus, County Executive
NOTE: APPLICATIONS FOR RESIDENT MEMBERSHIP MUST INCLUDE A COPY
OF A CURRENT DRIVERS LICENSE, TAX BILL OR UTILITY BILL (ie; electric, cable
or phone bill). Post Office box addresses will not be accepted. (A photocopy is acceptable.)
Applications should be accompanied by a check in the full amount of the golf
membership fee, payable to County of Orange
**************************************COMPLETE ALL LINES BELOW***********************************
Signature: ______________________________________________
Date: ____________________________ Date of Birth: _______________________________
PLEASE PRINT:
Name: _____________________________________________________________________________
MailingAddress:_____________________________________________________________________
City/Town: ___________________________________ State: ____________ Zip: ______________
Email Address: _______________________________ Telephone: ____________________________
Email and/or Phone number required for all memberships.
****************************** PLEASE CHECK APPROPRIATE BLOCK ******************************
Golf Course I will use most during 2021: Stony Ford or Hickory Hill
************************************* FOR OFFICE USE ONLY *************************************
Checked by: ______________________ How: Driver’s License ___ Tax Bill ____ Utility Bill ____
Cash/Check: ________________________________________
Date Application Received: ____________________________________________ Staff Initials: _______
Date Initial Information Entered in Chronogolf: ___________________________ Staff Initials: _______
MEMBERSHIP APPLICATIONS MUST BE RECEIVED PRIOR TO YOUR FIRST TEE TIME IN
ORDER TO RECEIVE THE DISCOUNT, NO EXCEPTIONS.
GOLF COURSE ADMINISTRATION MUST REVIEW AND APPROVE ALL MEMBERSHIP
APPLICATIONS AND MAY TAKE UP TO FORTY-EIGHT (48) HOURS TO PROCESS.
Application Page 2 of 2
