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Fishing Archery  Ice Derby 2013 camping gun clubhouse cook shack Membership App

 

SOUTH FITCHBURG HUNTING & FISHING CLUB, INC

P.O. BOX 687 WARREN ROAD

TOWNSEND, MA. 01469

(978) 597-8733 (Club’s number)

DATE: _____/_____/_____

APPLICANTS NAME: ___________________________________________________

MAILING ADDRESS: ___________________________________________________

CITY________________________________________________________________

STATE: ________ ZIP CODE: ____________ PHONE NUMBER: ________________

OCCUPATION: ____________________________ DATE OF BIRTH____/____/____

 EMAIL ADDRESS _____________________________________________

 

ADULTS (18-64)          JUNIORS (9-17)          SENIORS (65+)         LIFETIME

ENTRY FEE-$25.00      ENTRY FEE-$10.00      ENTRY FEE-$10.00               

DUES-$60.00             DUES-$36.00             DUES-$24.00             $450.00

$85.00                     $46.00                     $34.00

*LIFE DUES ARE PAYABLE OVER A 1-YEAR PERIOD. (SEE SECRETARY FOR DETAILS).

 

 

ARE YOU A MEMBER OF NRA? ___YES ___NO   MEMBERSHIP #______________

ARE YOU A MEMBER OF GOAL? ___YES ___NO

 

 

MEMBERS ARE EXPECTED TO HELP MAINTAIN AND IMPROVE OUR ASSOCIATION. PLEASE CONSIDER

THIS CAREFULLY BEFORE YOU SUBMIT THIS APPLICATION

 

THIS CLUB EXISTS ON VOLUNTEER HELP FROM ITS MEMBERSHIP AT WORK PARTIES AND FUNCTONS PLEASE LET US KNOW WHICH YOU FEEL YOU WOULD BE MOST INTERESTED IN IF YOUR HELP WAS CALLED UPON (LIST THE TOP 3)

 

ARCHRY___ GROUNDS___ RANGE___KITCHEN___RAFFLES___GOAL REPRESENTATIVE

HUNTER EDCUATION___ DERBIES­­___ OTHER (PLEASE LIST__________________________________

 

 

AS A CITIZEN OF, OR LAWFUL RESIDENT ALIEN IN THE UNITED STATES, I DO NOT BELONG TO ANY ORGANIZATION WHICH HAS, AS PART OF ITS PROGRAM, A GOAL TO CHANGE THE GOVERNMENT OF THE UNITED STATES BY LAWFUL MEANS. AS A MEMBER, I WILL SUPPORT THE GOALS AND PURPOSES OF THE CLUB AS OUTLINED IN THE CLUB BY-LAWS, AND WILL CONDUCT MYSELF IN A RESPONSIBLE MANNER AS BEFITTING A TRUE SPORTSMAN. I RELEASE THE CLUB FROM ANY RESPONSIBILITY FOR ANY INJURIES THAT I, OR ANY GUESTS, MIGHT SUSTAIN WHILE ON THE CLUB PROPERTY, IN ACCOORDANCE WITH THE ARTICLE XIV IN THE CLUB BY-LAWS. I FURTHER CERTIFY THAT I AM NOT A FELON.

 

 

SIGNATURE: _________________________________________________________

CLUB SPONSOR: ______________________________________________________

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DATE: ____/____/____ PAYMENT AMOUNT: $______________ CASH/CHECK.

RECEIVED FROM: ______________________________________________________

AS PAYMENT FOR DUES. MEMBERSHIP WILL NOT BE ACCEPTED UNTIL SWORN IN AT A GENERAL MEETING.  (Valid 90 days upon receipt)

 

RECEIVED BY: ______________________________________________________