APPLICATION

MAINE COWBOY MOUNTED SHOOTERS

2012 MEMBERSHIP APPLICATION

New___      Renewal____    CMSA#______      SASS#______

Mens____    Ladies____       Senior____    Wrangler____

Name____________________________    Date of Birth___________________

Address_________________________________________________________

Town__________________________    State_______    Zip_______________

Phone (____)_________________          Cell  (____)__________________

Email __________________________________________________________

Individual Membership: $25.00____ 

 Wrangler u/12: $15.00            ____                      

 Associate Member: $15.00      ____

*Family Membership: $40.00    ____  

*Please fill in separate form for each family member

As a member you will receive a newsletter and match results, advance notice of upcoming shoots.  You are able to vote at club meetings.  You will enjoy the sport and help promote gun safety as well as being part of a family sport.

Family Membership: Those persons living under the same roof in a spousal relationship and/or their children under the age of 21 who are still enrolled fulltime in school.

For more information contact:   Bill Ledoux, President 

                                                   6 Lady Pat Drive, Biddeford, ME.  04005

                                     207-282-2821          email:  cowboybill@maine.rr.com 

Liability Release Form 

I understand that I am participating in a sport, which contains dangers, and risks may arise, including, but not limited to, accidental injury, the forces of nature and illness.  In the consideration of the right to participate in these events and the services provided for me by the Maine Cowboy Mounted Shooters, Cowboy Mounted Shooting Association or Single Action Shooting Society and its agents, I have and do hereby assume the risks associated with such events.  The contestant shall at his own expense, defend management and/or all sponsors, their members, or employees from any and all such claims and indemnify, from any and all liability, damage and costs arising from injuries to person or property occasioned by any act or omission of the contestant.

Signature of Applicant Required _____________________________________

Parent/Guardian if u/18____________________________________________

Mail to: Patty Ledoux, 6 Lady Pat Drive, Biddeford, Maine  04005