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Last Name
First Name & Middle Initial
Street Address
P.O Box Number (if applicable)
City
State
Zipcode
Email Address
Phone Number
Incomplete applications or those without a signature and date noted below will be returned. Your signature indicates that the applicant has read and understands the membership rules and regulations posted on our website.
I HEREBY MAKE APPLICATION FOR 2024 MEMBERSHIP IN THE COCALICO SPORTSMEN ASSOCIATION. I CERTIFY THAT I AM AT LEAST 18 YEARS OLD AND AGREE TO ABIDE BY ALL RULES AND REGULATIONS OF THE CLUB INCLUDING POSTED SIGNS, AND VIOLATION OF SUCH MAY BE GROUNDS FOR DISMISSAL WITHOUT REMUNERATION.
I UNDERSTAND THAT ENGAGING IN FIREARM AND ARCHERY SHOOTING ACTIVITIES CONSTITUTES INVOLVEMENT IN A HAZARDOUS AND DANGEROUS ACTIVITY WITH ACCOMPANYING RISKS OF PERSONAL INJURY OR DEATH AND LOSS OR DAMAGE TO PERSONAL PROPERTY, AND HEREBY VOLUNTARILY ASSUME THOSE RISKS.
Applicant Signature
Date of Birth (For Age Confirmation)
Date Signed
Note: Your application will now be submitted to the Voting Membership at the next monthly Membership Meeting and upon acceptance you will receive an email with further instructions for payment of your initial Membership Dues and completing your online Member Profile
