RICHMOND ROD & GUN CLUB

                   P.O. BOX 26551  BLUNDELL CENTRE P.O.  RICHMOND, B.C.  V7C 5M9

                                  MEMBERSHIP APPLICATION  FOR 2009 TO 31 Mar. 2010

Applicant's Name (1)__________________________________________________Date______

                                             (First)                               (Last)

Address_______________________________________________________________________

City & Prov._____________________Postal Code ______________Email,____________________

Date of Birth ____________ Occupation _________________ Phone No. (_____)__________

                (Day/Month/Year)

NOTE:Date of Birth (DOB) reqd.  & Firearm Lic. # if applicable as per new firearm regulations.

Firearm Licence (FAC/PAL)No. ____________________________ Expiry Date _______________

IF FAMILY APPLICATION PLEASE COMPLETE THIS SECTION:-

Spouse's Name (2) __________________________ DOB ________________(day/month/year)

Juniors (under 19 years of age & living at home)

Junior (3) _______________DOB____________Junior (5)______________DOB___________

Junior (4) _______________DOB____________Junior (6)______________DOB___________

                (check one) New Member ___  Renewal _____

Please circle interests you may have:- Fishing,  Hunting,  Trap & Skeet,  Handgun/Airgun,  .22 Rifle,

                                                       Archery,  Other ___________________________

NOTE: New Temp. Range only allows Archery & Air gun! Sportstown B.C. 4991 #5 Rd. Richmond

ANNUAL FEE SCHEDULE (membership Year: Apr. 1st of current year to March 31st of following year).  Membership fee includes $5 Million Liability insurance coverage for one Member.  If your spouse or Junior(s) wishes to use the range facilities additional insurance at $8 per person per year is required.  *** (see below, name the person(s) ***  NOTE: Prorated fees for New Members after Oct. 1 now available.

Membership Fee    $______Juniors (under 19 Years of age)         45.00

         Senior Citizen & Spouse (over 65)      45.00

Additional Insurance$______Single Membership (over age 19)       80.00

           Family Membership (includes Spouse &

                                                        Juniors under age 19 @ same address)     90.00

                 

                   Spouse of Life Member             10.00

                            

Total Remitted $_________       ***Additional Insurance (per person)        8.00

ABOVE RATES ALL INCLUDE G.S.T.  (Our GST Reg. No. is  87296-8011 )

Any donations toward the New Building Fund are Gratefully Accepted.  $ _________

"Contact Us" for prorated fees, after 01 Oct.  New members only!

*** Additional Insurance?? (name the person(s)) ____________________________________

Membership No's (1) ______  (2)______  (3) ______  (4)  _____  (5)  _____  (6)  _____