Kincardine Nimrod Club

Membership Application

First Name____________________________ Last Name________________________________

Address_______________________

City: __________________________ Province______________________

Postal Code____________________ Telephone: ____________________ (Residence)

                                                 ____________________ (Business)

E Mail: ____________________________                KNC Key #___________________        

Fees for 2016

Choose one of the following:

Insurance (mandatory):

Add one of the following:

You need not purchase this membership/ insurance if you are a lifetime member of the CSSA, or have paid your annual CSSA membership privately prior to application; however, you must provide proof at the time of renewal or new application.

Total Due   $________________

                                Additional Information

Please complete the following information

Date of Birth______________.  Firearm Licence (PAL#) for Main Member________________________.

NB: If the applicant does not have a valid PAL, a Criminal Background Check is required and a copy presented with the application for membership.

For “Family Membership”; please include each members name and date of birth below:

Name: _______________________ DOB_____________________ PAL# ______________________

Name: _______________________ DOB_____________________ PAL#_______________________

Name: _______________________ DOB_____________________

Name: _______________________ DOB_____________________

Name: _______________________ DOB_____________________

What is your main interest in joining this club? ______________________________________________

For new members only, how did you hear about us? _____________________________________________

Restricted/Prohibited License holders only:

PAL/POL#___________________________

Membership renewal is due by December 8th of each year, or you cease being a member.

As a condition of membership in the Kincardine Nimrod Gun Club, I pledge to:

  1. Observe all regulations and restrictions of the Club Constitution and Range Rules.
  2. Observe all laws and regulations pertaining to the use and ownership of firearms.
  3. Promote firearms safety and sportsmanship.
  4. Refrain from any course of conduct involving firearms that may alarm the public.
  5. Encourage the lawful use of firearms for recreation and sport.
  6. I agree to the terms of payment as above.

Signature of Applicant(s) _________________________________ Date: _______________________