Waikato Airgun Club
Application for membership
First name:........................................................... Middle name:..............................................................
Surname:...............................................................
Firearms licence no. (members aged 16-18 years):......................................................
Family members (please list childrens' date of birth):
Name:..................................................................................................... Date of birth:......./......./............
Name:..................................................................................................... Date of birth:......./......./............
Name:..................................................................................................... Date of birth:......./......./............
Name:..................................................................................................... Date of birth:......./......./............
Name:..................................................................................................... Date of birth:......./......./............
Name:..................................................................................................... Date of birth:......./......./............
Address:.......................................................................................................................
....................................................................................................................................
City:............................................................................................................
Postal code:............................
Telephone no:........................................................
Mobile no:..................................................................
E-mail address:................................................................................
Membership fees (tick applicable box):
□ Adult (18 years and older): $35.00
□ Junior (younger than 18 years): $20.00
□ Family: $60.00
Payment method: Cash □ Bank Deposit (use name as reference) □
Bank account details: Westpac
Waikato Air Gun Club Association
03-1556-0424639-000
Range fees:
A range fee of $5.00 per member per day, visitors $10 per day.
The first shoot of a non-member will be free, on the second shoot a range fee of $7.00 will apply and thereafter the non-member will have to apply for membership.
By signing this form you agree that you have read and understood, and will comply to the WAGC constitution and rules.
Signature:...................................................................................................... Date:......./......./.............
Official use only
Membership number:.................................