Central Alabama Gun Club, Incorporated

Central Alabama Gun Club, Incorporated
Application for Membership

(Annual Dues $160.00, June 1 through May 31, First time initiation fee $100.00)
NAME
(First) (MI) (LAST)
ADDRESS
(Street Address, PO Box, or Route & Box #)
ADDRESS
(City, State, Zip Code)
PHONE
EMAIL ADDRESS
(For CAGC use only. It will not be provided to others)
NRA Membership Number
AGE
Emergency Contact Name
Relationship
Emergency Contact Phone
Certification
I pledge to obey all laws, rules, and regulations of Central Alabama Gun Club, Incorporated. I certify that I may own and possess firearms under the laws of the United States of America and the State of Alabama, and pledge to obey all such laws.

I further certify that I am knowledgeable in the use of firearms and firearms safety rules, and may safely use the facilities of Central Alabama Gun Club, Incorporated, without supervision of a range officer.
SIGNATURE

Clear
DATE

MonthDayYear
Date
Should be Empty: