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Life Membership - Basic Family
Membership Application
This is a Basic Life membership for a family. To add the ability to use the Rifle Range, you mist select the already a lifetime member Just need to add the Range from the Membership Page and then you will be able to use both the Rifle range until December 31st.
Membership Type
*
New Membership
Renewal Membershiap
*
Indicates required field
Your Name
*
First
Last
Your Date of Birth
*
Home Address
*
Line 1
Line 2
City
State
Zip Code
Country
Mailing Address (Complete only if different from Home Address)
*
Line 1
Line 2
City
State
Zip Code
Country
Home Phone Number
*
Cell Phone Number
*
Email
*
**Complete This Section - This Info is needed for Insurance Purposes**
Spouse or Significant Other
*
First
Last
[object Object]
Spouse or Significant Other Date of Birth
*
Choose One
*
Male
Female
Please Note: No Children under the age of eight (8) years of age allowed on the firing range
Children
Age 8 to under the age of 18
(living in the parents household)
Children under the age of 18 will age out of the Lifetime Family Basic membership once they turn 18
Children over the age of 18 (living in the parents household) must purchase their own membership
Child #1
*
First
Last
[object Object]
Child #1 Date of Birth
*
Choose One
*
Male
Female
Child #2
*
First
Last
Child #2 Date of Birth
*
Choose One
*
Male
Female
Child #3
*
First
Last
Child #3 Date of Birth
*
Choose One
*
Male
Female
Child #4
*
First
Last
[object Object]
Child #4 Date of Borth
*
Choose One
*
Male
Female
Child #5
*
First
Last
[object Object]
Child #5 Date of Birth
*
Choose One
*
Male
Female
Child #6
*
First
Last
[object Object]
Child #6 Date of Birth
*
Choose One
*
Male
Female
I, the undersigned do hereby make application as a member of the Belknap County Sportsmen's Association, Inc. I understand that the BCSA is a civic organization with the mission of promoting the outdoors, and supporting the local community. As a member, I pledge to attend and or support as many BCSA activities as possible in order to help the BCSA this goal.
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