APPLICATION FOR MEMBERSHIP 2008
P. O. Box 2246, CASTRO VALLEY, CA 94546-0246 (510) 569-0213
PLEASE PRINT LEGIBLY:
NAME ___________________________________________________________________________________________________________
DATE OF BIRTH _________________________________ PHONE NUMBER____________________________________
ADDRESS ______________________________________________________________________________________________________
CITY ____________________________________________________ STATE ____________ZIP _______________________________
BUSINESS OR OCCUPATION __________________________________________________________________________________
I hereby apply for membership in Chabot Gun Club. I certify that I am a person of good repute and that I have never been convicted of any felony or other crime of violence. I have read, understand and signed the agreement on the reverse of this document. I understand that this application is conditional and will be reviewed by the membership committee for approval prior to issuance of credentials. If I am admitted to membership, I will fulfill the obligations of good citizenship and good sportsmanship. I understand that failure to comply with any of the policies and/or rules of the Club may result in the termination of my membership.
SIGNATURE ________________________________________________________DATE ______________________
For your application to be considered, the agreement must be signed on both sides, initialed as to your choice of options on our privacy policy and accompanied by your remittance of the membership fee. This includes a $40 initiation fee and the pro-rated annual dues. See the chart below for the month you join. This fee pays your dues through the end of this year only. At the end of this year, to continue your membership, you must renew with a reaffirmation of the membership agreement and payment of the annual dues for the following year.
JAN. 112.00 FEB. 106.00 MAR. 100.00 APR. 94.00 MAY 88.00 JUN. 82.00
JUL. 76.00 AUG. 70.00 SEP. 64.00 OCT. 58.00 NOV. 52.00 DEC. 46.00
A receipt will be issued to you to use at the range for membership privileges while your application is being processed.
E-MAIL ____________________________________________________
(For Office Use Only: Member Number ________________B#_______________Entered:__________________)
CHABOT GUN CLUB, INC.
I agree to all conditions of membership listed in this application and agreement. I understand that violation of any item may lead to investigation by the Membership Committee with referral to the Board of Directors, resulting in a warning or the possibility of expulsion from the range or termination of membership, as per the Club’s bylaws.
1) I will obey all directives of the Rangemaster or staff.
2) I will abide by the Club’s bylaws (available at the range office), which are incorporated by reference and all policies announced by the Board of Directors.
3) I will handle firearms and other equipment safely at all times.
4) My behavior at the Club’s facilities will be courteous and non-confrontational.
5) I will conduct myself in accordance with good sportsmanship at all times.
As a member, I accept the following responsibilities:
1) Not to act in a way that brings harm to the Club.
2) Not to act in a way that interferes with the ability of another to use or enjoy the facilities of the Club.
3) Not to make false statements relating to the Club.
4) Not to misrepresent myself as an agent of the Club nor act in such a way that others may assume that I am an agent of the Club.
5) Not to create a potential safety violation by providing misleading or incorrect information or advice to another patron.
6) To avoid interference and distraction of patrons by conducting all solicitations only at or in designated areas.
7) To avoid interference and distraction of patrons by limiting photography to still-pictures only and only to and/or of members of my group and/or their equipment. I understand and accept that no video cameras are permitted on the range without express written permission of the Board.
I hereby waive any claim against Chabot Gun Club, Inc. and/or the East Bay Regional Park District and/or their staff, management, officers, directors, volunteers and/or agents, both as individuals and as corporate representatives (collectively defined as “Operator(s) and/or their Representatives”), from and against any and/or all loss, liability, claim, expense, costs, suits and/or damages of any kind, nature and/or description resulting directly or indirectly from my use of the Range’s facilities, my presence or participation at Range sponsored public activities, matches or events and any issues pertaining to paid or volunteer work or any interactions with the Operator(s) and/or their Representatives which may arise out of activities or conduct at this range. I further assume all risks inherent in my presence at or participation in activities at said Range, and release the Operator(s) and/or their Representatives for all liabilities which arise. I further agree that any disputes unresolved by negotiation must go to Mediation before resorting to final and binding Arbitration, utilizing mediation rules and arbitration rules of the American Arbitration Association, and to reimburse the Operator(s) and/or their Representatives for all attorney fees, costs and/or expenses related to any and/or all unsuccessful dispute resolution that I initiate and/or am a party to against the Operator(s) and/or their Representatives.
I understand that my voting rights and right to hold office will begin after a probationary period during which the admission process is completed and not earlier than January 1st of the year of the first annual membership renewal.
CHABOT GUN CLUB, INC. RESERVES THE RIGHT TO REFUSE SERVICE TO ANYONE.
I UNDERSTAND THAT PROVIDING FALSE OR MISLEADING INFORMATION TO ANY AGENT OF CHABOT GUN CLUB, INC. MAY BE CAUSE FOR TERMINATION OF MEMBERSHIP.
I HAVE READ, UNDERSTOOD AND AGREE TO THE TERMS OF THIS WAIVER AND RELEASE.
_______________________________________________________________________________ __________________
Signature Date
For your protection, our privacy policy is that, other than Board members and senior staff, only qualified candidates for Club office may contact you, through a mailing supervised by Club staff, at the address you list. Your name or other personal information will not be given to anyone without your written permission. If you would like to have your personal information shared with anyone else who requests it, please initial or mark below; otherwise this information will be kept private.
___________ Please SHARE my personal information with anyone upon request.