Bear Swamp Range Membership Application
To apply for membership please complete all questions.
Individual Membership Application
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Name
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Please enter a valid phone number.
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Street Address
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E-mail
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example@example.com
Place of Birth
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Country of Citizenship
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Do you have a CCW? If so, What State?
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If so, What State?
Are you a NRA Member?
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Are you a USCCA Member?
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In Case of Emergency Contact:
First Name
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Please choose which membership you are interested in
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VIP Membership $1750 - Includes 5 Stand at $10 per around, Pistol and 100/300 yard Rifle ranges with no range rental fees, reserved parking, Access to VIP sitting area, 20% Discount in Pro Shop (excludes firearms), 20% Discount on all training classes, 4 free guest per year & 12 guest per year at $10 per hour range fees or $10 per round of 5 stand
Platinum Membership $1000 - Includes 5 Stand at $10 per round, Pistol & 100/300 yard Rifle ranges with no range fees, 10% Discount in the Pro Shop (excludes firearms), 20% Discount on all training classes, 4 free guest per year & 12 guest per year at $10 per hour range fees or $10 per round of 5 Stand (Same guest limited to 4 visits)
Gold Membership $500 - Includes 5 Stand at $15 per round, Pistol & 100/300 yard Rifle ranges with $15 per hour range rental fees, 5% Discount at the Pro Shop, 5% Discount on all training classes, 2 free guest per year & 12 guests at $15 per hour range fees or $15 per round of 5 Stand (same guest limited to 4 visits)
Silver Membership $250- Includes 5 Stand at $20 per round, Pistol & 100/300 yard Rifle ranges with $20 per hour range rental fees, limited to 2 days of shooting per month & 6 guests at $20 per hour range rental fees or $20 per round of 5 stand (limited to 1 guest per month and same guest limited to 4 visits)
Are you under indictment or information in any court for a felony or any other crime for which a judge could have imprisoned you for more than one year, or are you a current member of the military who has been charged with violation(s) of the Uniform Code of Military Justice and whose charge(s) have been referred to general court-martial?
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Yes
No
Have you ever been convicted in any court including a military court, of a felony, or any other crime for which a judge could have imprisoned you for more than one year, even if you received a short sentence including probation?
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Yes
No
Are you a fugitive from justice?
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Yes
No
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Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any controlled substance?
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Yes
No
Have you ever been convicted as an adult or adjudicated as a juvenile of an offense that occurred after July 1, 2021 of a misdemeanor assault & battery on a family or household member pursuant to Section 18.2-308-1:8 or any substantially similar law of any jurisdiction?
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Yes
No
Are you subject to a court order restraining you from harassing, stalking, or threatening your child, or an intimate partner, or a child of such partner, are you subject to an emergency substantial risk order or substantial risk order?
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Yes
No
Have you ever been adjudicated legally incompetent, mentally incapable or adjudicated an incapacitated person and prohibited from purchasing a firearm or been involuntarily admitted to an inpatient facility or involuntarily ordered to an outpatient mental health treatment and prohibited from purchasing a firearm or been the subject of a temporary detention order and subsequently agreed to voluntary admission?
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Yes
No
Buyer acknowledges and agrees that Bear Swamp may run a background check on Buyer using publicly available records. Buyer agrees and consents to such background check and the use of Buyer’s information provided in this application or otherwise provided to Bear Swamp. Buyer warrants that the information it provides is accurate. Buyer acknowledges and agrees that Bear Swamp may deny membership to Buyer if the background check reveals information that, in Bear Swamp’s judgment, makes Buyer unsuitable for membership or if Buyer provides inaccurate information. Bear Swamp reserves the right to change our operating hours at anytime
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