| Deerfield Valley Sportsmen’s Club Annual Membership Application and Renewal 2012 (Due and payable by January 30, 2012) Life members must fill out forms only to keep membership valid. Please return the form below and signed release form with Annual Dues of $40.00 to: Deerfield Valley Sportsmen’s Club PO Box 1360, Wilmington, VT 05361 NAME: ________________________Date: ____________________ ADDRESS: ______________________________________________ _______________________________________________________ PHONE: ______________________email: ____________________ (Newsletters are send via e-mail.) FAMILY MEMBERS: SPOUSE___________________________________________ CHILDREN UNDER 18 YEARS: 1._________________________________________________ 2. _________________________________________________ 3. _________________________________________________ 4. _________________________________________________ Membership includes 2 adults and children less than 18 years of age Please remember that we are a non-profit organization and therefore any and all improvements to our Club are the result of fundraising, donations, and volunteer labor. Our goals for the upcoming season are improvements to the rifle range and trap range. $10______$20______$25______$50______Other______ Check the boxes below to let us know which activities with which you would be available to participate and/or volunteer to help: Trap/ 5-Stand Shooting – May-Oct. - Sat 10 am – 12pm AirGun Youth Marksmanship Program - April- December Harriman Reservoir Ice Fishing Derby – February Trout Stocking Day- May Youth Fishing Derby- June (2nd Saturday- Vt's Free Fishing Day) Peter Johnson Memorial Family Day - July Gerald Greene Memorial Shoot - August Youth shoots - October Club Clean-up Days Holiday Party – December DEEFIELD VALLEY SPORTSMEN’S CLUB RELEASE AND ASSUMPTION OF RISK I hereby expressly assume any and all risks associated with shooting at the Deerfield Valley Sportsmen’s Club (DVSC), Whitingham, Vermont. I know that shooting is considered by many to be a dangerous activity, and I hereby assume the risk of any and all injuries I may suffer due to the physical condition of the Deerfield Valley Sportsmen’s Club (DVSC), the acts and omissions of the other shooters who may be on or near the Deerfield Valley Sportsmen’s Club (DVSC) whether with or without permission, equipment failure, acts of god, and for any other reason. I have been advised that there will be other persons shooting and carrying firearms at the Deerfield Valley Sportsmen’s Club (DVSC) and I agree to act prudently and carefully to avoid causing them injury. I certify that I am familiar with the use and operation of the firearm(s) I will be using at the Deerfield Valley Sportsmen’s Club (DVSC) and that I am familiar with the rules of shooting and firearms safety. I release the Deerfield Valley Sportsmen’s Club (DVSC) together with their employees, agents, and representatives for any and all claims for personal injury, wrongful death and/or property damage which may arise in my favor and which may occur during or as a result of my presence at the Deerfield Valley Sportsmen’s Club (DVSC) as referenced above regardless of the cause of any such injury and including those which may be caused by negligence and/or any other cause. I give this release and assume all risks attendant thereto in consideration of being allowed to enter into and shoot at the Deerfield Valley Sportsmen’s Club (DVSC). This “release and assumption of risk” will be binding on my heirs, executors and assigns. I have read the above statement X________________________________ ___________________________________ _______ Full Name Printed Signature Date X________________________________ ___________________________________ _______ Full Name Printed Signature Date X________________________________ ___________________________________ _______ Full Name Printed Signature Date X________________________________ ___________________________________ _______ Full Name Printed Signature Date X________________________________ ___________________________________ _______ Full Name Printed Signature Date |
Membership Application and Waiver
Deerfield Valley Sportsmen Club Membership Info
| Why a Sportsmen's Club? Responsible sportsmen are concerned about conservation, safety, laws and regulations, game management, fish stocking, and many other topics that affect the environment. The Deerfield Valley Sportsmen's Club provides the facilities, support and encouragement to protect these interests not only for ourselves, but for future generations. Our Objective: To maintain and hand down to future generations that splendid heritage of the sportsmen we have received from the pioneer hunters and fishermen of Vermont; to encourage the children of our locality to love and enjoy the recreation of the outdoor life and to foster and develop a higher appreciation of the natural attractions of the woods and streams in this vicinity; to encourage proper protection of the fish, game, birds and the preservation of their natural homes; to help mold and develop public sentiments to uphold the statutes of Vermont as related to hunting, fishing, and the conservation of wildlife. Why join? Your membership will bring you together with your fellow sportsmen and friends, while at the same time working toward a common goal. |