PORT ANGELES GUN CLUB
EST. 1927
RENEWAL MEMBERSHIP FORM
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Each RENEWAL applicant, INCLUDING (for FAMILY memberships) ALL FAMILY MEMBERS OVER AGE 18, must agree to this form indicating compliance with the following pledge:
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I certify I am a citizen or resident alien of the United States of America and I am not a member of any organization or group, which has as any part of its program the intent or advocating of any attempt to overthrow the Government of the United States or any of its political subdivisions by force of violence. That I have never been convicted of a crime or am subject to any law that would restrict my right to ownership of a firearm, that if I am admitted to membership, I will fulfill the obligations of good citizenship and good sportsmanship and abide by the rules and regulations of the Port Angeles Gun Club, including my understanding and acceptance of the following Liability Release and Disclaimer statement:
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Liability Release and Disclaimer
As a condition of membership in the Port Angeles Gun Club, hereinafter referred as PAGC, I hereby release, discharge and agree to hold harmless PAGC. Its directors, officers, agents, and servants, and any sponsors, donors, and contributors of PAGC from all liability, claim, demands or actions that might arise out of: (1) any damage, loss, injury, or death which I might sustain, and/or (2) any theft, unexplained disappearance or damage that might befall any property belonging to me or in my possession on PAGC property.
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I acknowledge that I am aware of the hazards and risks inherent both to the use of firearms and to the physical proximity of any shooting activity, including but not limited to the accidental discharge of firearms and resultant personal injury or damage to property, I voluntarily and freely assume all such risks and accept and understand what is expected of me as a member of PAGC. Further, I voluntarily and feely assume personal responsibility for my safety and the safety of my guest. I have read, fully understand and agree to all terms of this liability and disclaimer statement. I understand that the terms herein are absolute and not mere recital. I have signed this statement after reading it and of my own free act.
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PRIMARY/SINGLE MEMBER (for Single, Family and Parent or Guardian for a Junior Membership)
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FAMILY MEMBERSHIP covers your immediate family and is limited to PRIMARY MEMBER, SPOUSE/COMPANION (also referred to as CO-MEMBER) and/or minor children/dependents under 21 years of age.) Place "NA" in all name spaces not used
SPOUSE/ COMPANION (Name information to be completed below ONLY for Family Membership)
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Sign Up Date
(MINOR AND/OR DEPENDENT CHILDREN UNDER THE AGE OF 21 THAT WOULD USE THE RANGE (any guest 18-20 must also sign), name of Junior(s) member.
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Sign Up Date
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Sign Up Date
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Sign Up Date
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MAILING ADDRESS
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CONTACT INFORMATION
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AGREE TO OUR TERMS & CONDITIONS
By checking the box you are acknowledging that all applicant names listed above have read the membership application, and you confrim the acceptance of all applicants to the Terms & Conditions of this application.
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