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LONDONDERRY FISH & GAME CLUB ON-LINE APPLICATION FOR MEMBERSHIP
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The field marked with (*) are required fields.
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E-MAIL:
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DATE:
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PLEASE SELECT MEMBERSHIP TYPE SOUGHT:
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HUNTER ED NO:
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ATTENTION: the field above requesting a Hunter Education Card number is for Junior Members seeking to enroll with the Hunter Education Endorsement. Special conditions apply; See membership terms and conditions for details
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FULL NAME: (last,first,mi)
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ADDRESS (No. and Street):
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CITY/STATE/ZIP
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TEL NO.(home)
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CELL NO.(optional):
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NRA MEMBERSHIP NUMBER:
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The Londonderry Fish & Game Club is a National Rifle Association-affiliated Club and as a condition of club membership, NRA membership is required. Those not members at the time of application must submit a membership number within 45 days of club membership.
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VEHICLE PLATE NUMBER/STATE:
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OCCUPATION:
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INTERESTS (check all that apply):
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HUNTING
FISHING
TRAPPING
TRAP/SKEET
BLACK POWDER/MUZZLELOADER
HANDGUN
RIFLE
CLASS III
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HOW DID YOU HEAR ABOUT THE CLUB?
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ATTENTION PLEASE READ CAREFULLY BELOW BEFORE PROCEEDING:
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The Applicant certifies that by completing this application process, they are IN FACT the person named herein and meet the following terms and conditions: 1. That the applicant is not under indictment or information in any court, for a felony, or any other crime in which incarceration for more than a year could result. 2. Applicant has not been convicted of a felony or any other crime for which a sentence of incarceration for one year or longer resulted. 3. Is not an unlawful user of and/or addicted to illegal drugs; 4. Is not a fugitive from justice; 5. Has not been legally adjudicated as a mental defective; 6. Is not the subject of (defendant) a court order restraining acts of harassing, stalking, or threatening; 7. That the applicant has not been convicted of misdemeanor domestic violence; 8. Has not renounced his or her United States citizenship and is not an alien illegally present in the U.S; 9. Applicant is not a member of any organization, whose purpose, goals and objectives and aims counter the bylaws, principles, goals or purposes of the LFGC. 10. That the applicant practices safe and ethical use of firearms, archery equipment, and laws of the state and country.
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Filling out this application does not constitute an offer of membership. When and if an offer for membership is made, and by accepting an offer of membership in the Londonderry Fish and Game Club, the applicant acknowledges that he or she will use the club for RECREATIONAL purposes only and LFGC shall not be liable for personal injury or property damage in the absence of intentional deeds. The applicant further acknowledges that the use, handling and operation of firearms, Archery equipment, and live ammunition presents certain inherent risks of serious bodily injury and or even death. Applicant therefore, agrees to abide by, and not violate any and all safety rules promulgated by the LFGC membership and/or its Board and Officers. The applicant further agrees to indemnify and hold harmless, the LFGC, its Officers and Directors from all liability arising from same. The applicant agrees to further indemnify and hold harmless, the LFGC, its Officers and Directors from any and all liability arising from the actions, omissions or bad conduct of applicant’s prospective guests and/or invitees.
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I HAVE READ THE INFORMATION CONTAINED ABOVE AND DO HEREBY CERTIFY WITH MY NAME BELOW, THAT I UNDERSTAND, ACKNOWLEDGE AND ACCEPT ALL TERMS AND CONDITIONS SET FORTH IN THE TERMS AND CONDITIONS FOR MEMBERSHIP.
I FURTHER CERTIFY THAT BY COMPLETING THIS APPLICATION, I AM REPRESENTING THAT I AM THE INDIVIDUAL CONTAINED HEREIN AND THAT AFFIXING MY NAME HAS THE SAME EFFECT AS PHYSICALLY SIGNING A DOCUMENT.
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