| Rodhouse Rut-N-Strut Hunting Application Please print application and mail back with your deposit to reserve your spot. We need to have your contact information on file in case of an emergency. Rodhouse Rut-N-Strut P O Box 218 Pleasant Hill, IL 62366 Tel: 217-734-2205 Fax: 217-734-2335 Name: __________________________________________________________________ First M.I. Last Address: ________________________________________________________________ City: _____________________________ State: ___________ Zip:__________________ Home Phone: ____________________________________________________________ Work Phone:_____________________________________________________________ Cell Phone: ______________________________________________________________ Email Address: ___________________________________________________________ Who to contact in case of emergency: _________________________________________ ________________________________________________________________________ Name and Number in Hunting Party: _________________________________________ Hunt Dates Requested: ____________________________________________________ If you would like to pay with a credit card please give us info: ________________________________________________________________________ Card number Type Exp Date Thanks Rick Rodhouse |