MEMBERSHIP APPLICATION

Starting in 2019 all new members must apply at the club and attend a range safety orientation.

General Membership Meetings are the 2nd Thursday of each month at 6:30pm, at the club house.     

      V 2020 BJR        

Deerfield Fish & Game Club, Inc.

Post Office Box 4828

Utica, New York 13504-4828

MEMBERSHIP APPLICATION FORM

 

Name: ___________________________________________________________     DOB: _____________________

Address: __________________________________   City: _________________    State: ____   Zip Code:  ____________

Email _____________________________________________________________________________________________

Cell Phone: _____________________________________     Home Phone:  ____________________________________

 

[] NRA # _________________________ [] Range Safety Officer Date expires ­­­­­­­­­­­­­­­­­­­­­____________________________

SELECT APPROPRIATE TYPE OF MEMBERSHIP

 

     Regular Membership (18 - 64 yrs old)    [] New     $50.00      [] Renewal     $30.00    Card No. XXXXXXX ___ __________

     Senior Membership (65 yrs and older)    [] New     $40.00      [] Renewal     $20.00    Card No. XXXXXXX ___ __________   

     Youth Membership (16-17 yrs old)*       [] New     $20.00      [] Renewal     $20.00    Card No. XXXXXXX ___ __________

    Active Military Membership                   [] New     $20.00      [] Renewal     $20.00   Card No. XXXXXXX ___ __________

    BE ADVISED:

     1.  ACCESS TO CLUB PROPERTY: Members are not authorized to be on the Club property without their membership card!    

      NO CARD ASSUMES NO MEMBERSHIP

 2.  MEMBERSHIP CARD: Members must carry their membership card on their person and use the card while on club property. The membership card is the only way to access the Club property, clubhouse, and ranges. The bump card readers on the ranges are the only form of sign-in/sign-out accepted.  Failure to use your card to access the club property, clubhouse, and/or ranges will constitute grounds for revocation of membership.  Sharing or loaning of membership cards is PROHIBITED and will constitute grounds for immediate revocation of membership.

 

  1. LOSS OF MEMBERSHIP CARD: In the event a membership card is lost, it is the member’s responsibility to immediately report it so that access may be suspended until a new card is issued. There is a $10.00 charge for replacement of a membership card and will require the member to appear for a new photo before printing.  Lost membership card may be reported by email to:  DFGC.SEC@gmail.com; or by phone (315) 725-2379.

 

  1. RANGES: The Club ranges are for MEMBERS ONLY, GUESTS ARE NOT ALLOWED to shoot on the Club ranges.

 

  1. HUNTING: Membership does not provide an automatic right to hunt on the Club property. Any member who would like to hunt on Club property must submit a request in writing.  Permission is limited and eligibility is determined by the Board.  Please refer to the Club Rules & Regulations for the proper procedure.

 

  1. ANNUAL MEMBERSHIP TERM: Annual Membership runs from January 1st to December 31st of each year. Membership dues are due in December of the preceding year, with a grace period through April 1st of the current year.  After the expiration of the grace period on April 1st any unpaid member will be dropped from the membership roster and will be treated as a new member (incurring a $20.00 initiation fee) when submitting a subsequent membership application form.  NOTE:  I new membership paid after September 1st will cover the balance of the current year and the following year. 

 

As an applicant or renewing member, I hereby acknowledge receipt of the Club Rules & Regulations, and I hereby agree to uphold and abide by the same.  I understand that my failure to uphold and abide by the Club Rules & Regulations will constitute grounds for immediate revocation of my membership.

Member Signature:  _________________________________________________________ Date:  _____________________

 

* YOUTH MEMBERSHIP REQUIRES THE SIGNATURE OF A MEMBER PARENT/GUARDIAN

As the Member Parent/Guardian, I hereby acknowledge that I am responsible to supervise the above sponsored

Youth Member at all times while on Club property and enforce compliance by the Youth Member of the Club Rules & Regulations.

 

Parent/Guardian Signature:  __________________________________________________   Date:  _____________________

 PAYMENT, PHOTO & COPY OF YOUR DRIVER’S LICENSE MUST ACCOMPANY NEW MEMBER APPLICATIONS, PHOTO &        DRIVER’S LICENSE IS NOT REQUIRED FOR RENEWALS. ALL APPLICATIONS MUST BE SIGNED BY APPLICANT.

              Application and check may be mailed to The Deerfield Fish & Game Club Inc., PO BOX 4828, Utica, NY 13504-4828

         General Membership Meetings are the 2nd Thursday of each month at 6:30pm, at the club house.     

      V 2020 BJR