Make A Payment – BuckDaddys Hunting Club

Please provide the following Information:
Member's Name*
First Last
Cardholder's Name*
First Last
Cardholder's Address
Street Address Address Line 2 City State ZIP Code
Home Phone
Cell Phone
Work Phone
Email
Property Assigned To. May provide county or city if you don't know the number.
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MEMBERSHIP - FULL PAYMENT
- Membership - Full Payment - $1,125 - NOTE - ON NEXT PAGE, SCROLL DOWN, SELECT OTHER, AND PUT IN $1125 UNDER QUANTITY. ($1 X 1125 = $1125) Thank you!
OPT OUT FEE for not attending a work day during the current membership year. See Bylaws.
- Opt Out Fee - $100
OPT OUT FEE for not attending a work day during the current membership year. See Bylaws.
Quantity
If paying an amount other than what is listed above, please specify amount and purpose. Option to pay in quantities of $1, $50, or $100 on next page.
- Other Amount NOTE - ON NEXT PAGE, SCROLL DOWN, SELECT OTHER AND PUT IN THE AMOUNT UNDER QUANTITY. Thank you!
If paying an amount other than what is listed above, please specify amount and purpose. Option to pay in quantities of $1, $50, or $100 on next page.
$ Amount:
Purpose:
By submitting this form, credit card or debit card, and electronic signature, I state and represent that I am 18 years of age or older, I am an authorized user on the credit and/or debit card being provided, I agree to the processing of such card, and give BuckDaddys authority to process such payments for the items and quantities indicated above, and in full accordance with the terms of the current Bylaws Agreement in place.
Required*
- I am the person listed above and agree to all the terms stated above.
Name
First Last
Authorized Person Submitting Form and Electronically Signing Bylaws Agreement:
Date
MM slash DD slash YYYY
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