Date:

 

Lone Pine Rangers

Membership Application

 

Name:

 

DOB:

 

Address:

 

 

 

 

 

City:

 

State:

 

ZIP:

 

Phone:

 

Alias:

 

SASS#:

 

CMSA#:

 

E-Mail:

 

 

Individual Annual Membership

$45.00



Family Annual Membership

$65.00

‪

Associate Member Non-Shooting

$25.00


Lifetime Membership Each Person

$200.00


 

 

 

 

 

 

 

Membership in Lone Pine Rangers includes: Certificate, badge and electronic news; regarding practices, shoots and meetings as well as meeting minutes.

 

Add Family Members:

Name:

 

DOB:

 

Alias:

 

SASS#:

 

CMSA#:

 

 

Add Children(s) name: (17 & under):

Name:

 

DOB:

 

Alias:

 

SASS#:

 

CMSA#:

 

Name:

 

DOB:

 

Alias:

 

SASS#:

 

CMSA#:

 

Name:

 

DOB:

 

Alias:

 

SASS#:

 

CMSA#:

 

Name:

 

DOB:

 

Alias:

 

SASS#:

 

CMSA#: