2012 Membership Application

Pronghorn Archery Club   4706 South Highway 59   Gillette, Wyoming 82718   www.pronghornarchery.homestead.com

PLEASE PRINT

Name:________________________________________________________________________

Name:________________________________________________________________________

Name: __________________________________________Date of Birth: ________________ (if under 18 years old)

Name: __________________________________________Date of Birth: ________________ (if under 18 years old)

Address:                                                                                                                                                                    

City:                                                                             State:                                       Zip:                                        

Home Phone:                                       Cell Phone:                                         E-mail:                                              

Very Important:  Please list the number of shooters who will be using the range.                       

Pronghorn Archery Club Range Rules and Regulations

1.        Broadheads, Guns, Firearms, Alcoholic Beverages and Drugs are not allowed at the range.

2.        Be aware of the DANGER ZONES behind the targets. (Looking for lost arrows).

3.        Children under the age of eighteen require adult supervision.

4.        A bow placed in front of a target means the target is unsafe to shoot (i.e. someone is behind the target looking for arrows).

5.        No sky pulling or sky drawing of bows.

6.        Hunting is NOT allowed at the range.

7.        Members and guests must sign a release, waiver and indemnity agreement.

8.        Members are not to hand out or loan gate keys. Doing so can lead to expulsion without refund.

9.        No walking or shooting backwards (backtracking) on ranges.

10.     Members are to wait for all shooters before advancing from the firing line.

11.     If searching for a lost arrow, place your bow in front of the target. Do not commence firing if you observe a bow in front of the target.

       I do hereby for and on behalf of myself, my heirs and legal representatives RELEASE AND FOREVER DISCHARGE the Pronghorn Archery Club (hereinafter referred to as “PAC”), and Campbell County its officers, directors, members, representatives, and volunteers, from any and all claims, demands and injuries, howsoever arising, whether caused by the negligent or intentional acts of PAC or any of it’s officers, directors, members, representatives, and volunteers, or by third parties, which injuries may be in any way related to my activities as a member of PAC and/or while on the premises of PAC, and all such claims are hereby WAIVED AND RELEASED, and I agree not to sue therefore. I acknowledge that my membership is contingent upon successful completion of the Range Safety Test.

I further agree to INDEMNIFY AND HOLD HARMLESS PAC, its officers, directors, members, representatives and volunteers from any and all liability which may incur to myself or my family members, however arising and whether or not caused by the negligent or intentional acts of PAC, its officers, directors, members, representatives and volunteers.

I have read and understand the foregoing. (Must be completed by legal guardian if under 18 years old).

                          Agreed to and Accepted this, the                       day of                                    ,   _2012_

                          Applicants Signature                                                                                                   

                          Printed Name                                                                                                             

·           2011 Club Membership: $20.00 (MUST BE / HAVE)

·           2011 Outdoor Range Membership: $35.00

·           2011 Locker Membership: $35.00

                    (Memberships expires November 30, 2012)

Make Checks Payable To:  PAC

Mail Application To:

PAC c/o Andy Turnquist

4706 South Highway 59

Gillette, Wyoming 82718

Please allow 2 to 3 weeks to receive your membership

Club Use: Date Received. ________ Cash $_________ Check $  ____________  

           Officer __________________________Card Number  ____________

Pronghorn Archery Club Safety Test

This test is mandatory and membership consideration is contingent upon: 1) A score of 80% or better and 2) the printed name and signature of the test-taker, and dating of this form.

                                                                                                                                                Yes    No

1.     Are broadheads allowed on the Club property?                                _______   _______

2.     Is hunting allowed on the Club property?                                         _______   _______

3.     Is sky pulling or sky drawing allowed?                                     _______   _______

4.     Is it ok to draw an arrow with someone down range?                         _______   _______

5.     Are fires allowed on the ranges?                                                          _______   _______

6.     Minors under 12 are allowed to shoot alone on Club property?          _______   _______

7.     Is alcohol allowed on Club property?                                                   _______   _______

8.     Is speeding permitted on Club property?                                             _______   _______

9.     Should you wait until all shooters are finished with their end?

     Before advancing to target to pull arrows?                                          _______   _______

10. If seeing a bow leaning against the front of a target butt.                     

     Would you continue to prepare to shoot?                                             _______   _______

11. Is back-tracking allowed on the Field lanes or 3D lanes?                    _______   _______

12. All found arrow shafts are to be returned to the pavilion?                   _______   _______

13. Are members allowed to give out gate keys?                                       _______   _______

14. Are firearms allowed on Club property?                                              _______   _______

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __     

 

Name (Print): _____________________________________________

 

 

Signature: ________________________________________________   Date: ____________________