Membership Application Form
Shooting Season 2012
Name: ______________________________________
Alias: ___________________________________
Address: ___________________________________
City, State, Zip:_____________________________
Phone:
_______________________SASS #:__________________NRA#: ________________________
(Please provide your NRA # - this is needed
to maintain our insurance with NRA)
E-Mail:_________________________________________________ (We
send out much info by e-mail)
May we release your
information to other members? Yes No
Release e-mail? Yes
No
Have you
completed RO training? (Please
circle) RO 1: Yes
No RO 2: Yes No
_____ Adult Annual
$
20.00 = _______
_____ Junior Annual
$
10.00 = _______
_____ Senior Annual
$
10.00 = _______
_____ Family Annual (up
to 3)
$ 30.00 =
_______
_____ Addition to
Family Annual Membership (ea) $ 10.00 x ____ = _______
_____ Life Member
$200.00 = _______
_____ Senior Life
Member
$100.00
= _______
_____ Family Life
Members (up to 3)
$300.00 =
_______
_____ Addition to
Family Life Membership (ea)
$100.00 x ____ = _______
Total Enclosed ญญญญ_________
Family memberships
-Additional Members:
Name: Alias:
Sass
#:
NRA#:
__________________ _______________________ ___________________ ____________________
__________________ _______________________ ___________________ ____________________
__________________ _______________________ ___________________ ____________________
__________________ _______________________ ___________________ ____________________
Makes checks payable and send to:
Liability Release Form
(You must sign and date this form to
participate)
I understand that I am participating in a
sport, in which certain dangers and risks may arise, including , but not
limited to accidental injury, the forces of nature, and illness. In
consideration of the right to participate in this event and the services
provided for me by the Sun River Ranger and its agents, I have and do hereby
assume the risks associated with such an event.
I, the contestant , shall, at my own
expense, defend management and/or all sponsors, their members, or employees
from any and all such claims and indemnify from any and all liability damage and
costs arising from injuries to person or property occasioned by any act or
omission by me, the Contestant.
Signature of contestant or in
the case of a minor, Parent or Guardian required.
_________________________________________________________________________
Signature
Date
_________________________________________________________________________
Signature (Second Adult in
Family Membership)
Date