MEMBERSHIP
APPLICATION
Last
First
Initial
Annual membership fee: $50 /
year with $25 first time initiation fee
Complete mailing
address:
Phone #
NRA Member Yes NRA #
D.O.B.
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
If
the applicant is under 21 years old, a legal guardian 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: