Range Member Renewal Application

Your Full Name

Your Birthday (YYYY-MM-DD)

Range ID:

Spouse's Name (if being added to membership)

Spouse's Birthday (YYYY-MM-DD)

1st Child (16 to 17 years old and if being added to membership)

1st Child Birthday (YYYY-MM-DD)

2nd Child (16 to 17 years old)

2nd Child Birthday (YYYY-MM-DD)

Address

City, State, Zip

Cell Phone Number

Your Email (for monthly newsletter)

Emergency Name

Emergency Number

List any skills that may benefit the range (construction, concrete, web design, carpentry, chainsaw experience)?

If active NRA Member, what is your NRA number

Are you currently a NRA Range Safety Officer (RSO)
YesNoNo, but would like to become one

Acceptance of Rules and Regulations:
I agree that no one under 16 is ever allowed on range or in parking lots

I agree to follow all rules and regulations of the gun range

I agree to be bound by our Release From Liability Waiver when using the range

I agree that I am solely responsible for my guests/child(s) at the range and that they MUST stay with me at all times

I agree to watch the "Introduction to Range Safety and Etiquette - Firearm Safety" Safety Video at the bottom of this page

Any addition comments?

By clicking the "Send" button below, you agree to follow all the rules and regulations of Washington County Tactical Range