Clone of Dutchess County Long Rifles Inc. Youth Enrollment Form

Dutchess County Long Rifles Inc. Youth Membership Form 2026
Please note that the membership year runs: January 1st to December 31st.
The yearly membership fee will be $50, with a max of $100 per family (cash or check).

The fee will be waived for any youth who has joined November 1,2025 or later.

- A parent/guardian will be required to sign a waiver IN PERSON prior to youth participation.
Youth Name

First NameLast Name
Youth DOB

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Were you previously a part of the Dutchess County Long Rifles Club?
Youth Gender
Parent/Guardian Name

First NameLast Name
Parent/Guardian Phone Number
Parent/Guardian Email Address (**Please note that DCLR conducts most of its communications via email. It is critical that you check your email frequently!)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Photo Release: I hereby grant permission to Dutchess County Long Rifles Inc., its representatives, and authorized media outlets to photograph, video record, and/or interview my child during events or activities associated with Dutchess County Long Rifles Inc.I understand that these images, videos, or audio recordings may be used in promotional materials, publications, social media, websites, and other media related to the organization’s mission. I agree that these materials may be used without further notice, review, or compensation, and I waive any rights of ownership or royalties connected to their use.
Should be Empty:

Dutchess County Long Rifles Inc. Youth Membership Form 2026