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Range Family
Membership Application - 2023
This is a Range Family Membership for 2 or more people living in the same household (following the age restrictions below). The 2023 Family Range membership starts now and expires on December 31, 2023.
All Range Membership allows you to use the Range and the Archery targets.
Membership Type
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New Membership
Renewal Membershiap
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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Indicates required field
Your Name
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First
Last
Your Date of Birth
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Home Address
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Line 1
Line 2
City
State
Zip Code
Country
Mailing Address (Complete only if different from Home Address)
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Line 1
Line 2
City
State
Zip Code
Country
Home Phone Number
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Cell Phone Number
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Email
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**Complete This Section - This Info is needed for Insurance Purposes**
Spouse or Significant Other
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First
Last
[object Object]
Spouse or Significant Other Date of Birth
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Choose One
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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 over the age of 18 (living in the parents household) must purchase their own membership
Child #1
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First
Last
[object Object]
Child #1 Date of Birth
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Choose One
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Male
Female
Child #2
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First
Last
Child #2 Date of Birth
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Choose One
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Male
Female
Child #3
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First
Last
Child #3 Date of Birth
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Choose One
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Male
Female
Child #4
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First
Last
[object Object]
Child #4 Date of Borth
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Choose One
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Male
Female
Child #5
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First
Last
[object Object]
Child #5 Date of Birth
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Choose One
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Male
Female
Child #6
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First
Last
[object Object]
Child #6 Date of Birth
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Choose One
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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.
Anyone using the range must be a current member, in good standing, and have in his/her possession a valid Range card. No one under the age of eight (8) shall be allowed on the Range, which is defined as the area beyond the gate. Any member under the age of eighteen (18) must be accompanied by, and supervised, at all times, by a parent or responsible adult in possession of a valid Range card. Any member(s)/person(s) using/utilizing the range agrees to and assumes all responsibility/liability for any/all injuries/property damage, to himself/themselves, or others, from whatever cause or reason and further agrees for himself/herself, his/her heirs, executors and assigns to indemnify and hold harmless Belknap County Sportsmen’s Association, its officers, directors, members and assigns from any/all injuries/damage/claims to which may arise from his/their use or presence on the Range of whatever nature and however caused whether from negligence, recklessness, intentional or willful, wanton reckless misconduct By continuing to submit this application, I signify that I have read, understand
and agree to abide by and adhere to the Belknap County Sportsmen’s Association Range Rules.
ALL NEW RANGE MEMBERS WILL GET THEIR RANGE CARDS AFTER COMPLETING THE RANGE ORIENTATION!
Range orientations will be scheduled by us after we have received and accepted your application. We will contact you to set up your orientation. If you have any questions, please call Range Master Bruce Klinger 603-707-6398
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