Membership App

   ALL NEW APPLICANTS AND CONTINUING MEMBERS WILL COMPLETE UPDATED APPLICATIONS AND MAY BE SUBJECT TO A BACKGROUND CHECK. ANY APPLICANTS THAT ARE CONVICTED OF A FELONY NEED TO PROVIDE LEGAL VERIFICATION OF GUN RIGHTS. THIS IS TO MEET THE STATE OF FLORIDA HUNTING AND FIREARM REGULATIONS.

    NEW MEMBER Club dues will be $925.00, renewing member’s dues will be $900.00. Deposit of 300.00 by March 15, all dues must be paid in full by April 30. Renewing members not paid in full at this time will result in loss of membership renewal, but may apply to rejoin as new members, at a cost of $925.00, if positions are available. Personal checks with insufficient funds will be returned to the member and loss of membership may result. DUES COVER THE COST OF CLUB LEASE, FOOD PLOTS (SEED & FERTILIZER) CORN, LOCKS, GATES AND ROAD IMPROVEMENTS.

 ALL MEMBERS ARE TO COMPLY WITH THE LAWS OF THE STATE OF FLORIDA.

 MEMBERSHIP APPLICATION PLANTED PINES HUNT CLUB 10/11

 

NAME____________________________________________________________________________

CONTACT #'S_________________________    DRIVERS LICENSE #___________________________

EMAIL ADDRESS____________________________________________________________________

SPOUSE’S NAME IF HUNTING WITH YOU _______________________________________________

 NAMES OF CHILDREN UNDER 18 YEARS OF AGE THAT WILL BE HUNTING WITH YOU

 _________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

HAVE YOU, YOUR SPOUSE, OR ANY DEPENDENT EVER BEEN CONVICTED OF A

FELONY OR VIOLATION OF ANY GAME LAWS?                      YES______ NO______

IF YES EXPLAIN:___________________________________________________________________

_________________________________________________________________________________

  WHO RECOMMENDED YOU TO THIS CLUB? ___________________________________________

     AS A MEMBER I DO AGREE TO ABIDE BY ALL CLUB RULES AND REGULATIONS AND ALL STATE AND FEDERAL GAME LAWS. I UNDERSTAND AND AGREE THAT NO MEMBER, GUEST, OR FAMILY MEMBER SHALL HOLD PLANTED PINES HUNT CLUB, ANY BOARD MEMBER OR THE LEASOR RESPONSIBLE OR LIABLE FOR ANY DAMAGES DUE TO AND NOT EXCLUDING THEFT, MISCONDUCT, INJURY OR ACCIDENTS. IT IS UNDERSTOOD THAT ANY PERSON ENTERING THE LEASE PROPERTY (CLUB, CAMPSITE, ECT.) THEY SHALL DO SO AT THEIR OWN RISK.

MEMBER SIGNATURE______________________________________ DATE_________________

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