Blue/Gray Charity Deer Hunt '08
January 17th, 18th & 19th
Please submit a separate form for each hunter registered.
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Name: 
Address: 
City:    State:     Zip: 
Home Phone:    Daytime Phone: 
Email:  
Age:   Occupation: 
Land/Guide Request(Former Hunters): 
Group Hunting Request: 

Payment Method:
Check   *PayPal   Visa   Mastercard  
Credit Card No:
Security Code:** 
Exp. Date: /

Amount authorized to charge to credit card:

Signature: ___________________________________________   

        2-day standard hunt - $850

      Optional Saturday afternoon hunt (Jan. 19th) - $175

      Optional Sunday morning hunt (Jan. 20th) - $175

  *Hunters that pay using PayPal, must complete registration form and fax or mail it in.
**If paying by credit card, we will need the 3- or 4- digit security code found on the back of your card in addition to the 16- digit account number.

If paying by check, please make payable to:  The MLC Community Foundation.

Please fill out the above form, this page, and then follow the directions below.

Please return form to:  Montgomery Lions Club
                                  P.O. Box 94
                                  Montgomery, AL  36101   -OR-   Fax to:  334-356-1185