Application

Daviess County Fish and Game Association

PO Box 1565

Owensboro, KY 42302

270-925-8343 or 270-302-9467

www.daviesscountyfishandgame.com

APPLICATION FOR MEMBERSHIP

Date_________          Fee Paid $______________               $ ______________

                                                                        MEMBERSHIP                                                        INITIATION

APPLICANT___________________________________________________________________________

AGE________ PHONE______________________CELL ______________________WORK_____________

ADDRESS_____________________________________________________________________________

                         NO.             STREET/PO BOX                                           CITY                                    STATE                                ZIP

OCCUPATION__________________________________________________________________________

SPOUSE OR FIANCE` NAME_______________________________________________________________

OTHER MEMBERS OF HOUSEHOLD:

  1. _________________________________________________________________AGE_________
  2. _________________________________________________________________AGE_________
  3. _________________________________________________________________AGE_________
  4. _________________________________________________________________AGE_________

I, OR MEMBERS OF MY FAMILY PLAN TO USE THE FOLLOWING FACILITIES:

CAMPING_______ TENT_____TRAILER_______PICKUP CAMPER______ RV________SWIMMING________

PICNIC_______FISHING______ARCHERY________TRAP___________RIFLE RANGE_________

I HAVE READ THE RULES FOR GOVERNING CONDUCT BY ME, MEMBERS OF MY FAMILY, GUEST OF MY FAMILY WHILE ON THE FARM AND WILL BE RESPONSIBLE FOR THEIR ACTIONS.

MY HUNTING/FISHING LICENSE NUMBER IS _____________________________________________________

                                                                           APPLICATION WILL BE REJECTED WITHOUT A VALID AND CURRENT LICENSE #

SPONSORED BY__________________________ SIGNED ___________________________________________

                                   CLUB MEMBER                                                                                       APPLICANT

For club use:

Please let us know why you would like to become a member at Daviess County Fish and Game? Will you be willing to volunteer to help on the farm and or events?

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