Swamp Membership Application

Swamp Membership Application

Complete this membership application. All fields are optional unless marked required.
Applicant Information
Full Legal Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
Date
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Occupation / Employer
Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please select the membership tier you are applying for:

Founding 100 Member LIMITED OFFER - 100 Memberships Available $1,000 One-Time Lifetime Payment No Activation Fee EXCLUSIVE LIMITED OFFER - Only 100 Lifetime Memberships available. One-time payment of $1,000 grants permanent lifetime membership with no recurring dues and no activation fee. Includes solo member full facility access, 2 guest passes/month, additional guests $30/day, and 10% off matches, ammo, Swamp branded apparel, events & training. This offer is strictly limited to the first 100 approved applicants and will not be renewed once capacity is reached.
Membership and Shooting Background
Years of Shooting Experience
Types of Shooting

Other
Types of Shooting - Other
Have you completed any formal firearms training courses?
Formal firearms training details
Current Credentials

Other
Agency / Unit / Branch
Eligibility Initials
Initials - I am at least 18 years of age
Initials - I am legally permitted to possess and purchase a firearm under applicable state and federal law
Initials - I have never been convicted of a felony or any crime of domestic violence
Initials - I have not been adjudicated as mentally defective or involuntarily committed to a mental institution
Initials - I am not currently under indictment or information for a felony
Initials - I am not an unlawful user of, or addicted to, any controlled substance
Initials - I am not subject to any active restraining or protective order
Initials - I am not prohibited from possessing a firearm under the laws of North Carolina or the United States
References
Reference 1 Name

First NameMiddle NameLast Name
Reference 1 Relationship
Reference 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference 1 Current Swamp Member?
Reference 2 Name

First NameMiddle NameLast Name
Reference 2 Relationship
Reference 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference 2 Current Swamp Member?
Application Details
Why are you applying for membership?
How did you hear about Swamp Tactical Training Center?

Other
Referral - Member Name
Other - Please specify
Describe your understanding of and commitment to firearm safety
Have you ever had a range membership revoked, been expelled, or cited for a safety violation?
If yes, please explain
Signature and Declaration
Applicant Signature
Applicant Printed Name

First NameLast Name
Applicant Date of Birth

MonthDayYear
Date
Application Date

MonthDayYear
Date
Office Use Only
Application Received Date

MonthDayYear
Date
Reviewed By
Decision
Decision Date

MonthDayYear
Date
Office Use Notes
Should be Empty:

Swamp Membership Application

Applicant Information

Membership and Shooting Background

Eligibility Initials

References

Application Details

Signature and Declaration

Office Use Only