Online NRGSC Individual Membership Application 2022-2023

Individual membership application.

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* 1. Member's Full Name:

First Name:

Last Name:

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* 2. Member Contact Information

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 3. I certify that I am not prohibited from legally owning a firearm or participating in club affairs by local, state or federal law. I have read and agree to abide by the NRGSC range rules and bylaws at www.nrgsc.org . I understand that any violation will result in my expulsion from the club and the termination of my membership. (Your typed name acts as your signature.)

Name:

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* 4. I certify that I am at least 18 years old and state under pain and penalty of perjury that I am not prohibited by federal, state or local laws from possessing or using firearms. I understand that activities at this club involve firearms. I am aware of the risks and hazards and agree to hold harmless the Northern Rio Grande Sporting Club (NRGSC), its officers and anyone acting on behalf of the club from any and all liability while participating in club shooting activities or any other activity on NRGSC property. I also assume responsibility for any harm caused by me at said activities.

I acknowledge that I have read and agree to abide by the NRGSC range rules found at nrgsc.org/regulations and NRGSC Bylaws found at nrgsc.org/regulations/nrgsc-bylaws. I understand that any violation of these rules and bylaws may result in my expulsion from the club and the termination of my membership.

Name:

Your Date of Birth: (MM/DD/YYYY)

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* 5. If you are a renewing member please give your Membership Card Number here. (This is the number of your gate card enter the number only) If you are a new member then please type New Member in this box.

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* 6. You MUST attach a COPY of proof of NRGSC Safety Training.

If you completed in-person safety training prior to July 2020 then please take a picture or scan your card and submit it here. Only PDF, PNG, JPG, JPEG files are supported. If you no longer have proof of your in-person safety training please take the online safety training course on our website. If you completed the online training then please upload the electronic certificate of training you received.

PDF, PNG, JPG, JPEG file types only.

Choose File

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* 7. If you are making a donation to our club then please enter the amount of the donation in the box below. Note that the total amount in Q8 must be the sum of $100 + the amount you enter here. Please enter whole numbers ONLY, no $ and no decimals. We need the amount of any donations seperate from the membership amount for record keeping purposes.

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* 8. TOTAL PAYMENT TO NRGSC:
Annual dues are $100. Payment by credit card through the secure app STRIPE. Please enter whole numbers ONLY, no $ and no decimals in the box to the right of the slider. The amount entered here should be $100 + any donation listed in Q6.
Club membership includes access and use of the range facilities by the member listed on this application as well as voting privileges in club functions.
Membership from July 1, 2022 to June 30, 2023, paid anytime, no prorating. Replacement cards are $10.00.

100 - $100 USD

Annual membership = $100

1000 - $1000 USD

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i We adjusted the number you entered based on the slider’s scale.

You will pay at the end of this survey.