Please Mail to:
Birds Landing Hunting Preserve
2099 Collinsville Rd  Birds Landing, CA 94512
or Fax to (707) 374-2814

Name:

Company Name:    (if applicable)
 
Street Address:

City:      State: California Arizona Colorado Montana Nevada New Mexico Oregon Utah Washington     Zip: 

E-Mail: 

Home Phone:               Daytime Phone: 

Type of Card:  Choose One 10 Bird Card 20 Bird Card 30 Bird Card 40 Bird Card Corporate Membership         Price:  $

Pre-Paid Picking (# of birds x $2.50):  $        Total Due:  $

Payment Method:     Cash:       Check: 
Visa / MC #     Exp:  3 Digit Security Code: 

Billing Address (If different from above):

Street Address: 

City:      State: California Arizona Colorado Montana Nevada New Mexico Oregon Utah Washington     Zip: 


Signature:_________________________________

Check here if rental dog needed          Recommended by: 

Membership cards, along with a copy of current rules and regulations, may be
picked up at the clubhouse on the member's first hunt of the season.
Membership cards will not be mailed out.
Card holder must accompany all guests.
_______________________________________________________________________________________________
For office use only

Approved By:______________      Date:________    Bonus:________    Check#:__________

       Fill out form, print, then mail or fax to Birds Landing Sporting Clays for processing.