$20.00 - [] Casual Membership [] Youth membership (ages 16 - 17)
Donation $_____ [] Range [] General
$30.00 - [] Family Membership
(Family means 2 memberships, Husband and Wife.)
[] New memberships require a member Sponsor: _____________________________
[] Youth memberships require Signature of Parent or Guardian: _________________
Member information
Name: __________________________ Address: ____________________________
City: ______________________ State, _______Zip Code: __________ - _________
Home Phone: ____________________ Cell Phone ___________________________
Email Address: ______________________________________ DOB: ________
Family Member information (spouse)
Name: ____________________________________ Cell Phone ___________________________
Email Address: ________________________________________ DOB: ___________________
Checks or money orders made payable to The Deerfield Fish Game Club must accompany this application. Mail both application and check to The Deerfield Fish & Game Club Inc., PO BOX 4828, Utica, NY 13504-4828. Each member will receive a yearly membership card; this card must be carried with you when on club property. Your card is your authorization to be on club property and to use the facility. NO CARD ASSUMES NO MEMBERSHIP. If you do not receive a card or lose your card, a replacement can be issued upon your proving payment was made to the club. Replacement cards take time to produce, do not call from the gate without a card expecting access to the club. You are not authorized on property without a card.
I pledge to support the Constitution and bylaws of the Deerfield Fish and game club and will work with other club members for the betterment of our club and sporting activities. The Ranges are members only, No Guests are allowed on the Ranges. You may bring a guest to a club meeting. Members must sign in on the range before setting up or shooting, members found shooting without being signed in or without their membership card will be asked to leave the range.
Signature: __________________________________ Date: ______________
Deerfieldfishandgame.com 
