MEMBERSHIP APPLICATION
FORT HALLECK VOLUNTEERS ® Inc.

Mail completed application and fees to:
FORT HALLECK VOLUNTEERS
c/o Douglas J. Thomsen
777 Court Street
Elko, NV  89801

E-Mail -- fhvolunteers@fthalleck.com

You can type your information in the fields below

SASS Name    SASS#
NAME         RO: 1 or 2 (check one)
ADDRESS     CITY   
 STATE       Zip      PHONE    
Email:        NRA#:

WHEN ACCEPTED INTO MEMBERSHIP IN THE FORT HALLECK VOLUNTEERS, I AGREE TO THE FOLLOWING CONDITIONS:

• I CERTIFY THAT I AM A CITIZEN OF THE UNITED STATES of AMERICA OR AN ALIEN LEGALLY RESIDING OR I VISITING IN THE U.S.A.
 
• I AM NOT A MEMBER OF ANY ORGANIZATION OR GROUP HAVING AS ITS PURPOSE OR ONE OF ITS PURPOSES THE OVERTHROW BY FORCE AND/OR VIOLENCE OF THE GOVERNMENT OF THE UNITED STATES OR ANY OF ITS POLITICAL SUBDIVISIONS.

• THAT I HAVE NEVER BEEN CONVICTED OF A FELONY OR CRIME OF VIOLENCE.

• WHEN ADMITTED TO THE MEMBERSHIP, I WILL FULFILL THE OBLIGATION OF GOOD SPORTSMANSHIP AND GOOD CITIZENSHIP, AND BEHAVE LIKE A LADY OR GENTLEMAN.

INCLUDED WITH THIS APPLICATION & WAIVER IS MY $50.00 FOR SINGLE MEMBERSHIP. MAKE CHECK PAYABLE TO FORT HALLECK VOLUNTEERS.
TOTAL  AMOUNT ENCLOSED .......................................................... $

LIST ALL CHILDREN BETWEEN THE AGES OF 12 AND 18 YEARS OF AGE THAT WILL PARTICIPATE IN ACTIVITIES OF THE CLUB. PLEASE UTILIZE ADDITIONAL FORMS IF NEEDED.

Name    Age    Alias    SASS#

Name    Age    Alias    SASS#

Name    Age    Alias    SASS#

FORT HALLECK VOLUNTEERS ® Inc.
GENERAL RELEASE & LIABILITY WAIVER 

I                                                               (SHOOTER GIVEN NAME) hereby acknowledge that I have voluntarily applied to participate in and/or observe the sport of Cowboy Action Shooting and its related activities including, but not limited to any adult event, children’s games, entertainment, food service and merchandise vendors.  On behalf of myself, my heirs, distributes, legal representatives, next of kin and assigns agree to the provisions set forth below: 

1.       I hereby release, waive, discharge and covenant not to sue, make a claim against the person or persons or property of or prosecute the Fort Halleck Volunteers ® Inc or any of their affiliate organizations, range property owners, directors, shareholders, agents or employees, herein referred to a RELEASEES.

2.       I hereby agree to indemnify and save and hold harmless the RELEASEES and each of them from any loss, liability, damage, or cost that RELEASEES may incur die to the presence of or any act of the Undersigned while the Undersigned participates in or observes related activities being presented by RELEASEES, whether caused by the passive or active negligence of RELEASEES or otherwise.

3.       THE UNDERSIGNED IS AWARE THAT THE PARTICIPATION IN OR THE OBSERVATION OF THE SPORT OF COWBOY ACTION SHOOTING WITH LOADED FIREARMS, AND RELATED ACTIVITIES IS A HAZARDOUS ACTIVITY & HEREBY AGREES TO ASSUME ANY AND ALL RISKS FOR PROPERTY DAMAGE, PERSONAL INJURY OR DEATH.

4.       The Undersigned gives consent to whatever medical care might be provided or available on the premises.

5.       THE UNDERSIGNED AGREES THAT ANY UNSAFE ACT, INCLUDING THE USE OF ALCOHOL, AND/OR CONTROLLED SUBSTANCES WHILE INVOLVING THE HANDLING OR USE OF ANY FIREARM OR WHILE ARMED, WILL BE CAUSE FOR EXPULSION FROM THE RANGE, AND FORFITURE OF ANY AWARDS EARNED.

6.       I further agree to abide by all RULES & REGULATIONS as defined and contained in the current revised edition of the S.A.S.S. Shooters Handbook. 

 I am over the age of eighteen (18) years and I bind myself to the terms of this agreement.

 

Date:                        Print Given Name:                                                           SASS #:                              

 

Signature:                                                                                                                             

 

Address:                                                                 City/State:                                       Zip:                     

 

Phone: (     )                                     Alias:                                   E-Mail:                                                 
 

I am over the age of eighteen (18) years and I am signing this agreement on behalf of a person under the age of eighteen (18) years.  I covenant that I have all legal authority to act on behalf of such minor person, and I bind said minor, and/or myself to the terms of this agreement.

 

Date:                         Given name of Minor:                                           AGE:               SASS#                  

 

Print Adult Name:                                                 Signature:                                                                    

 

Address:                                                                City/State:                                       Zip:                     

 

Phone: (    )                                    Alias:                                       E-Mail:                                                

 

Include payment. You can only pay by check.