Are you a new member? If yes, all new members must attend a club safety course to obtain a range pass before they can shoot.
yesno

2023 Membership Number (If applicable)

Applicant Name

Street

City

State

Zip

Membership Type
Family (Spouse&children under 18) - $85.00Senior (over age 18) - $75.00Sr. Citizen (age 65 & over) - $45.00Junior (under 18) - $10.00

Date of Birth

Phone Number

Email

Motor Vehicle Make

Motor Vehicle Model

Motor Vehicle Color

Motor Vehicle Registration

Spouse's Name

Child's Name and Age

Child's Name and Age

Child's Name and Age

Child's Name and Age

Club Membership card must be displayed at all times while of club grounds.
You MUST HAVE a range pass before using any range.
An LTC or FID must be presented to receive a range pass valid for using any ranges. If not presented, the range pass will be valid only for the archery range.
A Range Pass will be issued to a club member age 15 or older after completing a class and passing a ten-question test.
Range Pass must be displayed at all time while using any firearm or archery range.
ATV and DIRT BIKES NOT ALLOWED.

I have read the Chicopee Sportsmen's Club Rules and Regulations and Shooting Protocols and will abide by them. I have received copies of the Chicopee Sportsmen's Rules and Regulations and Shooting Protocols. I/We have read the General Use Permission & Rule Agreement while on Club Grounds and agree to the terms as does our chld, if any, and I/WE shall agree to fully abide by the same, and agree to bring no actions of any kind against the club, it's officials, member or instructors. Membership valid from January 1st thru December 31st.

Applicant Signature

Date

Spouse Signature

Date

I/We, the undersigned participant, parent(s), guardian(s) or custodian(s) of a minor child of: (Name of Member(s) or Minor Child, or Both, Whichever Applicable) {Print Name(s)} whose address is: permit the minor or myself to use the grounds of the above-named club subject to the following conditions which I/We understand and hereby acknowledge and agree to:

1. The club, its officers, directors, members & instructor(s) shall not be held liable, either criminally or civilly for the actions of our child or I/We or us or any others while on or off or to and from any of the land of the club, including all roads, ranges, and buildings. I/We shall indemnify the club for nay damages, criminal or civil caused by us while on club grounds. I/We are not criminals, felons or illegal aliens, and are not being treated and have not been treated for any mental illness.

2. Participation in any activity on the club grounds is the knowing and free choice of the participant, child and parent(s), guardian(s) or custodian(s) and we assume responsibility for any possible risk, danger, or possible damage(s) associated with such recreational activities, and accept the "natural and outdoor conditions" of the club's land and not limited to roads, ranges, and buildings. The club and any official/members or instructor(s) are not responsible for any losses, occurrences or damages of any person on the grounds or to and from the same.

3. All persons, their child and his parent(s), guardian(s) or custodian(s) understand that safety is of (primary) concern and agree to abide by any rules of the club and safety instructions (written or verbal) of the instructor(s) while on club grounds including the penalty of expulsion for not following instructions (written or verbal) or violating any rule, regulation or law, federal or state. No refunds.

4. All participants and their parent(s), guardian(s) or custodian(s) agree to refrain from wasting, littering or abusing the premises or interfering with the supervision of the instructor(s) while on the club grounds or using all roads, ranges, buildings or land.

5. In addition, and specifically, no person or participant or parent(s), guardian(s) or custodian(s) shall fight, swear, or verbally abuse other or use any firearm, bow and arrows or weapons of any description in a careless, negligent or threatening manner. No illegal firearm, rifle or shotgun or any weapon(s) shall be used on club grounds. All persons must meet the specification(s) of all state or federal laws and regulations and the approval of the instructor(s)/supervisor(s) of the activity.

I/We have read the above and agree to the terms as does our child, if any, and I/We shall agree to fully abide by the same, and agree to bring no actions of any kind against the club, it's officials, member or instructors.

Signature(s) of Adult Member(s) age 10 or over

Primary: Date:

Secondary: Date:

**PLEASE NOTE** There is a $4 processing charge added to cover the Paypal fees and the postage fee’s. The standard postage fees will also be included. $2 for Family memberships and $1 for Junior, Senior and Sr. Citizen memberships. Once submitted and paid, you will receive your membership card and key by mail as soon as possible.

Δ