Douglas County Hunting Association

Membership Application

Welcome to our club.

     Member (and spouse if an active hunter) must fill out application completely and legibly, sign, date and send with dues (Checks made payable to Douglas County Hunting Association). Mail application(s) and payments yearly to: 

     James Rutledge DCHA

     8600 Estelle Street

     Douglasville, GA. 30134

Name: _______________________________    Returning Member#: ___________

                                                                              New Member(s) Check: _________

Address: _____________________________________________________________

City:__________________________________     State: _____     Zip: ____________

Home Phone: ___________________     Work Phone: __________________

Cell Phone: ____________________     Email:________________________________

 

Contact Information in case of Emergency:

Name: ________________________________     Phone #: _____________________

 

I understand that as a member of the DCHA I am hunting at my own risk. I also understand that I cannot and will not hold the DCHA or any of its officers/ land owners responsible for any accident or damage to person or property. This waiver shall remain in force and renewed automatically for each year during my membership. I will send in an application each year that I remain in the club with the proper fees.

New members will receive a membership packet ASAP with gate key.

Signature: ___________________________________  Date: ______________

Application not valid if not signed

Dues-check your selection:

New Member $600.00 _____  Current Member:

                                                  Received before May 1st  $500.00 ___

                                                  After May 1st  $550.00 ___

                                                  Electric Fee: Per Camper/Tent or Shelter  $75.00 ___ Campers w/ 2 AC units $100.00____

Please circle the main county(s) you will be hunting:

Coweta           Carroll          Haralson          Taliaferro           Warren

For Further Information Contact : Jim Rutledge 678-836-8726   

Email: rutman8600@att.net