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