Title: Membership Application Post by: Pronto on December 12, 2010, 05:42:16 pm NEVADA GUNFIGHTERS
Membership Application & Waiver (Required for each individual Member) Name:____________________________________________________________________Age:____________ Address:__________________________________________________________________________________ City:_____________________________________________State:___________________Zip:_____________ Phone:___________________________________________Cell:_____________________________________ Email:_____________________________________________________________________________________ Thank you for your interest in the Nevada Gunfighters, We are dedicated to Firearm Safety as well as the preservation of the historical Old West through re-enactments, demonstrations and presentations. In the interest of Insurance and Safety we ask that you also complete the following: Do you have any medical condition that might preclude you from performing any of the following physical tasks: Set Assembly, stunts, pratfalls, simple tumbles, fist fight sequences, heavy lifting etc. If yes, please explain: ___________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Have you ever been arrested or convicted for any of the following offenses: Domestic Battery/Violence: Yes { } No { } Weapons violations Yes { } No { } Any Felony Yes { } No { } Upon acceptance as a member of the Nevada Gunfighters you agree to pay an annual membership fee of **$25 per person or **$45 per family. This membership fee includes your portion of the Liability Insurance program. ** Prices subject to change. Upon acceptance, you agree to sign the following documentation: Nevada Gunfighters Hold Harmless documentation Non-compete/ Proprietary agreement Minor Child Waiver – Where applicable Member Emergency Medical information. Signed:_______________________________________________________ Date:______________________________ If you are signing on behalf of minor child, print name of child also. Child Name___________________________________________________ Date:______________________________ Copy and paste into, or attach to an email with the Hold Harmless, fill out, send to nvgunfyter@yahoo.com |