Family Membership Application

A. Personal Information

First Name

Last Name

Current home address (Number, Street, (Apt.)

City

Province

Postal Code

Phone Number

Email Address

Date of Birth (YYYY-MM-DD)

Occupation

Emergency contact phone number

Spouse / Partner First Name

Spouse/ Partner Last Name

Spouse / Partner Phone Number

Spouse / Partner Email Address

Spouse / Partner Date of Birth

Do you have a valid Possession & Acquisition Licence ?

Yes No

B. Tell us about yourself:

Are you 18 years old or older?

Yes No

Do you have a valid Possession & Acquisition Licence?

Yes No

Do you currently own any firearms?

Yes No

Have you hunted in the past two years?

Yes No

Have you gone fishing in the past two years?

Yes No

Do you currently own a fishing licence?

Yes No

Have you been a member before?

Yes No

Are you ready to Volunteer to help in various club activities as and when required?

Yes No

Is a Member sponsoring your application?

Yes No

C. Terms and Conditions:
1. All relevant federal, provincial, and local firearm and fishing laws and regulations, as well as all Club rules, must be adhered to at all times.
2. Damage to the facility will incur a fee and may result in termination of your membership.
3. Minors (children under 18) must be supervised by an adult Member at all times while on Club premises.
4. Members are responsible for their guests and must ensure that guests adhere to all Club rules. Guests must sign a waiver before using any Club ranges.
5. Members are encouraged to participate in Club events and activities. Active involvement contributes to a vibrant Club community.
6. Renewal of your membership is contingent upon your participation in at least two volunteer events in the year following the acceptance of your membership.
7. Any disputes or grievances should be reported to the Club Board of Directors for resolution. Members are expected to cooperate in a respectful manner.
8. Membership fees for the following year are due on December 31st.
9. Personal firearms and fishing equipment must be stored safely and securely. The Club is not responsible for lost or stolen items.
10. Members must respect the environment. This includes proper disposal of waste.
11. Failure to adhere to these rules may result in the termination of your membership.
12. The Club reserves the right to amend these rules and regulations at any time. Members will be notified of any changes.
13. The Club reserves the right to accept or decline any membership application at its sole discretion. Membership applications will not be considered until this application, the corresponding fee and photograph has been received.

Your submission of this application implies acceptance of the above terms and conditions.

D. Identifying photograph
For identification purposes, we require applicants to submit a photograph taken within the last six months with the following conditions:
1. The photograph should contain your head and shoulders.
2. The photograph must be clear, sharp and in focus with natural skin tones.
3. There must be no strong shadows on the face.
4. The face must be square to the camera with a neutral expression, eyes open and mouth closed.
5. If you wear glasses, your eyes must be clearly visible, and there should be no glare or reflection from the lenses. Sunglasses or tinted glasses are not allowed.
6. No hats or head coverings are allowed, except for religious reasons provided your full face is clearly visible.

Either upload or E-mail your identifying photograph to from your e-mail address that you specified above in this application form.

OFAH membership is required for Range Access. Please select individual or family membership. If you have your own OFAH membership, please provide proof of it to after the submission of this form.

E. Membership fees

Application submitted month

FOR OFAH (Adult 18+ $50, Spouse/partner to Adult – $25, Child Age 18-25 – $15, Child Age 13-17 – $5, Child Under Age 13 – $0)

Spouse need to be added

Yes No

No. Of Adult Child (Age 18-25)@ $15

No. Of Teen Child (Age 13-17)@ $5

No. of Child Under Age 13 @ $0

Total Amount To Be Paid

Total: $

We accept application payments through e-transfer (). If this is not possible, please contact us at this e-mail address () to arrange an alternative form of payment.

F. Signature
By submitting this application, you confirm that all the information provided above is true and correct.

I have read the above Terms & Conditions and agree to them

I agree

I understand that in case if the rules are not followed by me or my Guest, I will be responsible and my membership may be terminated.

I agree

In place of your signature, type your full name here:

Your application will only be considered at the next Board of Directors’ meeting after your Fee and Photograph have been received.

RR1, 1075 Bo-De Lane St. Jacobs, ON | Tel: (519) 664-2951 | E-Mail:

Total: $

Location

Contact Persons

Opening Hours

(Club Lounge & Bar)

RR1, 1075 Bo-De Lane St. Jacobs, ON | Tel: (519) 664-2951 | E-Mail: document.getElementById("eeb-653636-272547").innerHTML = eval(decodeURIComponent("%27%49%6e%66%6f%40%57%61%74%65%72%6c%6f%6f%52%6f%64%61%6e%64%47%75%6e%2e%43%61%27"))*protected email*

Family Membership Application

Total: $

Location

Contact Persons

Opening Hours

(Club Lounge & Bar)

RR1, 1075 Bo-De Lane St. Jacobs, ON | Tel: (519) 664-2951 | E-Mail: