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 ___
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