Membership Application

Are you renewing your membership?*
YesNo

Have you received a Green Safety Card?*
YesNo

YOUR INFORMATION (Required)
Your Full name* (First, Last)

Email*

Primary Telephone Number*

Secondary Telephone Number

Street Address*

City*

Province/State*
—Please choose an option—ABBCMBNBNLNSNTNUONPEQCSKYTALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

Country*
CanadaUSA

Date of Birth*

Firearms License #* (PAL)

Do you have a restricted PAL?*
YesNo

FAMILY DETAILS (Optional)
Spouse Name, Date of Birth (YYYY-MM-DD)

Child Under 18 Name, Date of Birth (YYYY-MM-DD)

Child under 18 Name, Date of Birth (YYYY-MM-DD)

Child under 18 Name, Date of Birth (YYYY-MM-DD)

Child under 18 Name, Date of Birth (YYYY-MM-DD)

EMERGENCY CONTACT

Emergency Contact Name*

Emergency Contact Telephone # *

Emergency Contact Relationship*
—Please choose an option—SpouseFriendMotherFatherBrotherSisterDaughterSonGrandmotherGrandfatherGranddaughterGrandsonAuntUncleNieceNephewCousin

Additional Comments (optional)

PLEASE REMEMBER
DO NOT SUBMIT PAYMENT UNTIL
YOUR APPLICATION HAS BEEN CONFIRMED.

Do you prefer confirmation via email or telephone?
EmailTelephone

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