I have read and understand the Range Procedures and Rules listed on the Range Membership page. By checking the box below, I agree to abide by these rules and procedures at all times while at the range.

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-----OFFICE USE ONLY-----

Member Number:________________________________   

Membership Level:_______________________________. 

Family Plan enter spouse full name_____________________________________

Add 21+ Children: ________________How many children under 21____________

Veteran / EMS / Fire / LEO:_______________________

Annual Dues:____________ Pro-rated Dues:_____________  

Payment Method: __________ Initiation Fee: $200 / $300 / NONE

Total Amount Paid:_____________________. 

Date Payment Received: __________  Balance Due: ______________

Concealed Carry Permit: YES / NO

Frontline Defense Staff Signature:_____________________________

Date: ____________________________

Range Orientation Completion Date: _________________________

Certified By: ________________________

Member Signature: ______________________________________ 

Date: ____________________________________