MEEKER SPORTSMAN’S CLUB, INC.

P. O. Box 1325,  Meeker, CO 81641-1325

Membership Application

NAME:________________________________________________________

SEX: M_____  F_____    BIRTH DATE:_____________

MAILING ADDRESS:______________________________________________

EMAIL ADDRESS:__________________ PHONE:_______________________

N.R.A. Member:    Yes / No    Marital Status:  Married _____   Single_____

List immediate family members that reside with you and their birth date.

________________________________________________________________________________

________________________________________________________________________________

Membership entitles the applicant and their immediate household family members who reside with them, to utilize club facilities, equipment, and programs in a responsible and safe manner.  A guest, accompanied by a club member only, is limited to use the range one time only, after which they must become a member of the club.  Family members must be accompanied by the member.

ANNUAL MEMBERSHIP FEE IS $20.00 PLUS A $20.00 WORK-MEETING PERFORMANCE FEE:

(With the following exceptions:)  Check appropriate box.

I (we) agree to obey all policies and rules, while insuring the maintenance and protection of all club equipment and facilities.  I (we) have received and read a copy of the Club rules and regulations, and I (we) fully understand each of every one.  I (we) agree that failure to obey and abide by such will result in the loss of Club Membership and privileges.

I understand that muzzle loaders, black powder, tomahawk, knives, bows and arrows, and modern firearms and the use of these items are dangerous and assume all risks and hazards incidental to such participation, including transportation to and from the range waive, release, and agree to hold harmless the organizers of the Meeker Sportsman's Club, Inc. their members and officers.

Signature: ___________________________________               Date: _______________