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Membership Application

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Pronto
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« 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
« Last Edit: March 26, 2012, 05:43:14 am by Pronto » Report Spam   Logged

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