KERN RIVER VALLEY GUN ASSOCIATION
PO Box 958
Wofford Heights, CA 93285
www.krvga.com
*Operating on a non-discriminatory basis with a special use permit from the U.S. Forest Service*

SPOUSE MEMBERSHIP APPLICATION

for the spouse of a member is $20. Please fill out the form below. Fields marked 'required' must be filled out. You will enter your credit card information after clicking the 'Proceed' button at the bottom of the form.

Member's Name (required):Membership Number* (required):
*NOTE: If new member and haven't received number, enter the date of joining
Spouse Information:
Full Name (required)

Residence Address (required)

—Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY
Mailing Address (if different)

—Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

Phone with Area Code (required) Email (required)

Are you a member of: The National Rifle Association (NRA)? NOYES - Number
Are you a member of: California Rifle and Pistol Association (CRPA)? NOYES

To help defend our 2nd amendment rights, the KRVGA encourages its members to join the NRA and CRPA.

PLEDGE:

I certify that I am legally entitled to own and use a firearm in compliance with the laws of the United States of America and the State of California; that I am not a member of any organization which has any part of its program that attempts to overthrow the government by force or violence; that I have never been convicted of, or have an outstanding warrant for, a felony under the laws of the United States, the State of California, or any other state, government, or country; that I have never been convicted of an offense, including certain Prohibiting Misdemeanors, or have an outstanding warrant for, as listed in the California Penal Code that prohibit owning and/or possessing firearms; that I am not an alcoholic or illicit drug user; and that, if I am admitted to membership, will fulfill the obligation of good sportsmanship and good citizenship, and obey all club rules.

Select date of acceptance:
BY CHECKING THIS BOX: I, THE APPLICANT, FULLY UNDERSTAND AND ATTEST TO THE TRUTH OF THE ABOVE INFORMATION AND DECLARE MYSELF SUBJECT TO THE PROVISIONS OF THE ABOVE PLEDGE.
(The above box must be checked to accept the pledge, it will represent your signature)

Continue by thoroughly reading the following:

RELEASE AND INDEMNIFICATION AGREEMENT

IN CONSIDERATION of my being given permission to observe and/or participate in the shooting, sporting and outdoor activities at the Kern River Valley Gun Association, I agree to thoroughly read and enter into this release and indemnification agreement by checking the agreement box at the end.

I am entering into this agreement freely, voluntarily, and specifically state that:

1. I am not dazed, suffering from shock or under the influence of drugs or alcohol;
2. I understand that this is a full and complete release and indemnification agreement; and
3. There has been no fraud or other conduct used in obtaining my signature and agreement to this document.

I will comply with all rules and regulations. If I have questions, or observe any unusual or unnecessary hazard during my participation, I will immediately bring such to the attention of the nearest official, and I have read all range rules and will comply with completely.

I understand that the observation and/or participation in the shooting, sporting and outdoor activities will expose me to certain risks inherent to the use of firearms and related activities. These include, but are not limited to, personal or bodily injury, death and/or property damage.

I understand the range is under audio and visual surveillance and agree to be recorded while at the range.

I agree to assume and accept the dangers inherent in the observation and/or participation of the shooting, sporting and outdoor activities.

I represent that I have no drug, health or mental problem that could or will interfere with my observation and/or participation of the shooting, sporting and outdoor activities.

I agree that I am responsible for my own safety and the safety of any guest or child that I may bring to the premises of the Kern River Valley Gun Association.

I agree that the Kern River Valley Gun Association, its members, officers, directors, employees, agents, representatives, affiliates, subsidiaries, successors or assignees and all participating groups and persons officially connected with the activities, including but not limited to the Kern River Valley Gun Association, will not be liable if I, my guest or child suffer any personal or bodily injury, death or property damage as a result of ordinary negligence.

I further agree that in the event that the Kern River Valley Gun Association, its members, officers, directors, employees, agents, representatives, affiliates, subsidiaries, successors or assignees and all participating groups and persons officially connected with the activities, including but not limited to the Kern River Valley Gun Association, and become liable by way of contribution, indemnification, judgment, verdict, award or otherwise, to any other party as a result of my actions, negligence or injury, I agree to indemnify and hold harmless the Kern River Valley Gun Association, its members, officers, directors, employees, agents, representatives, affiliates, subsidiaries, successors or assignees and all participating groups and persons officially connected with the activities, including but not limited to the Kern River Valley Gun Association, from any and all claims, demands, actual legal costs or other costs or expenses arising out of said actions, negligence, or injury, no matter who might bring said claim, if any be brought.

Select date of acceptance:
I HAVE READ THE FORGOING RELEASE AND INDEMNIFICATION AGREEMENT, AND
BY CHECKING THIS BOX REPRESENT AND WARRANT THAT I FULLY UNDERSTAND IT AND AGREE TO IT.
(The above box must be checked to accept the RELEASE AND INDEMNIFICATION AGREEMENT, it will represent your signature)
CAUTION! READ BEFORE CHECKING BOX.