CAMELOT FOREST CONSERVATION ASSOCIATION, INC.

For member to be in compliance with Camelot Forest Conservation Association, Inc. (CFCA) Member/Landlord Policy, this form must be completed and submitted to the office on or before June 1st of each year. A $100.00 fee is due with this registration form.

NAME:__________________________________________________ LOT #:___________ SEC:_________

ADDRESS:______________________________________________________________________________

CITY:_________________________________________________ STATE:_________ ZIP:_____________

PHONE NO:______-______-_____________

RENTAL AGENCY(S), IF APPLICABLE:_____________________________________________________

RENTAL DURATION: WEEKLY ( )    MONTHLY ( )    YEARLY ( )    SEASONALLY ( )

I have received and read CFCA Member/Landlord Policy and the Rules and Regulations for Rentals and understand that I will be held responsible for any damage to CFCA common property caused by my renters. I will insure that I will provide a copy of CFCA's Rules and Regulations for Renters to my renters and that, should circumstances warrant it, I grant CFCA agent permission to go upon my property.  
 
SIGNATURE OF MEMBER/LANDLORD_____________________________________________________

FEE RECEIVED:____________ CFCA AGENT:________________________________________________

                                                     DATE:_______________________  
 
CC/CFCA
       MEMBER/LANDLORD

Please notify the office should you no longer rent your property