New Membership Application – Nenameseck Sportsmens Club

First Name

Last Name

Spouse First Name (Family Only)

Spouse Last Name (Family Only)

Year of Birth

Mailing Address Line 1

Mailing Address Line 2

City

State

Zip Code

Email Address

Home Phone #

Cell Phone #

Limited (Black Powder&Archery Only)

Yes

No

LTC/FID#(Req. for Firearm Range Access)

LTC or FID Expiration Date

Spouse LTC/FID#

Spouse LTC or FID Expiration Date

Are you a Member of G.O.A.L?

Yes

No

Are you a Member of the NRA?

Yes

No

INTERESTS: Handguns?

Yes

No

INTERESTS: Long Guns?

Yes

No

INTERESTS: Archery?

Yes

No

INTERESTS: Air Rifle?

Yes

No

Sponsor's Name

I Reviewed the Club Rules? (https://nenameseck.com/wp-content/uploads/2022/09/RANGE-RULES-8-30-2022-1.pdf)

Yes

I Reviewed the Club Bylaws? (https://nenameseck.com/wp-content/uploads/2019/01/Nenameseck-Club-Bylaws-1-17-2019.pdf)

Yes

I Reviewed the Liability Waiver? (https://nenameseck.com/wp-content/uploads/2019/01/NSC-Club-Liability-Waiver-2019.pdf)

Yes

I acknowledge that all future communications are now via email. All future renewals will be completed via website.

Yes

No

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