MEMBERSHIP
APPLICATION
_ _ _
Last First Initial
Complete
mailing address:
_
_
Phone # _
NRA Member Yes____
NRA Instructor? ________________________________
NRA Classification _
This Membership Endorsed by _
INDEMNITY AGREEMENT
The undersigned, in consideration for membership in the Panola County Gun Club, hereby assumes the entire responsibility and liability and does release, indemnify and hold harmless the Panola County Gun Club and the landowners, their agents, servants, employees and members from and against any and all losses, expenses, causes of action, demands, and claims made against the Panola County Gun Club or the landowners because of any injury or alleged injury (including death) to the undersigned, or damage to the property of the undersigned, whether caused by the negligence of the Panola County Gun Club or the negligence of the landowner or otherwise, arising from any source or arising out of or incident to the undersigned being a member of said Panola County Gun Club and being on the property leased to said Panola County Gun Club by the landowners.
EXECUTED THIS _____ DAY OF ___________________ , 20_______
_________________________ _____________________________
Witness Applicant
a. If applicant is under 21 years old
Father
or legal guardian must
also
sign.
b. If applicant is married woman,
husband
must also sign.
The undersigned has received a current copy of the Constitution and By-Laws and Range Policy of the Panola County Gun Club, Inc. and has read, understands, and agrees to abide by and comply with all provisions of same.
Applicant: ________________________________________