Buck Forest
Membership Application
Please Print This Form Out. Then Fill Out And Mail or Fax To:
Buck Forest
c/o Emil & Sheryl Billitz
205 Waterwood Lane
St. Augustine, Florida 32095
Fax: 904-823-3799
Name: _____________________________________________Date Of Birth:__________________
Address:____________________________________________City:_________________________
State:______Zip Code:_____________Phone:(H)___________________(C)___________________
E-Mail:_______________________________Type Of Employment:__________________________
(Please Print Clearly)
Please Answer The Following Questions With "YES" Or "NO"
Have You Ever Been Charged With Any State Game Violations? __________
Is "QDM" Something That You Believe In? __________
Please Mark An (X) For Your Arrangements Needed If You Become A Member
Camp House/Bunk _________ Camp Site __________ Either ___________
Please Tell Us In Your Own Words Why You Would Make A Good Member At Buck Forest.
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Please Read The Statement Below And Sign If You Agree.
I have read the "Buck Forest Rules & Regulations" and I agree that if I were to become a member that
I would follow them without discord. I understand the "QDM" measures being made and I will aid in the upkeep of these
measures. Further more, I understand that becoming a member of Buck Forest that I will have to pay the membership
dues in a timely manner and that any violations against Buck Forest policies could result in suspension of membership
without refund.
Signature: ____________________________________________ Date: ______________________
