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Blue Rock Sportsmans Club
New Membership Form
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* Indicates required question
Email
*
Your email
Company
*
Enter place of employment
Your answer
Is this a New Member Application
*
Yes
No
Referring Member Email address
For New Members only. The Referring Member Email address must be entered.
Your answer
Cell Number
*
i.e. 501-xxx-xxx
Your answer
Alternate Email
Your answer
First Name
*
Your answer
Last Name
*
Your answer
Paying for Someone else
If your company or someone else is paying for your membership enter the name below.
Your answer
Address
*
Your answer
DOB
*
MM
/
DD
/
YYYY
Select your four digit pin access code.
*
This is required to access the club's GATE for the current membership year
Your answer
Spouse First Name
Your answer
Spouse Last Name
Your answer
Children's Names
Your answer
Are you a school/church trap coach?
*
Yes
No
Name of school or church?
This is only needed if you answered yes to the previous question.
Your answer
Please select your shooting discipline:
*
Skeet
Trap
Sporting Clays
Hunter
Required
Select your age range:
*
Under 21
22-30
31-40
41-50
51-64
65-69
70 and over
Guest fees are $1/day for all non-members and all guests must complete the guest form. I have read and will follow the rules listed on our website.
*
I ACKNOWLEDGE
1
2
I DO NOT ACKNOWLEDGE
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