Membership Info Form

Please provide the following contact information:

First Name
Last Name
Middle Initial
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Type of MEMBERSHIP	Regular, Youth, Family (submit second form for each person)
Work Phone
Home Phone
FAX
E-mail
Name of Guardian	Youth under age 18 (Lead Exposure Warning)

Regular Membership/Year            $145.00  (+$3.00 range use fee/day)

Family Membership/Year             $145.00   (+ $75.00 for each extra family member, 4th family free)

Youth Membership/Year             $6.00 ($2.00 range use fee/day) REQUIRE GUARDIAN SIGNATURE

Guest                                          $10.00/day  (Sign in at club, application not required)

All include NFA/Shooting Federation of Canada Insurance for this Facility