Membership form

The following form is for new members or members renewing their annual membership. You have the option of completing the form below and clicking submit or complete the club-membership-eform print it. You will need to complete this as well as the Release and Indemnity ADF and mail it to the address on the top of the membership form.

PLEASE NOTE you cannot mail cash, all club fees can be paid by direct deposit using the details at the bottom of the form or Cheque attached to the nomination forms.

Once you have completed the online membership form you will be taken to the payment page.

You can complete the below form and submit it online.

Applicants for Local Membership MUST be current members of SSAA National.

Members of the pistol section must also be general members.

Local Membership is subject to approval by the committee.

New Membership or Renewal

General or Pistol (Pistol members must also be General members)

Full Name

Date of Birth*

day

month

year

Phone Number

E-mail:*

Address:*

Street Address Town State Post Code

Postal Address if different to above

Street Address City State Post Code

SSAA National #*

SSAA Branch (Q-??)

Rifle Licence#

Expiry Date

day

month

year

Pistol Licence #

Expiry Date.

day

month

year

Type of General membership

Number of PISTOL memberships (Must also be member of Rifle)

Adult is for a single General section membership aged 18-65

Family is for General for self, spouse/partner, immediate family 11-18yrs

Junior is for single General membership 11-18years

Senior is for single General membership 65yrs

Pension is for single General membership with current (aged) pension card

Pistol is an extra to ONLY join or renew a single membership for Branch Pistol.

Eg. Senior with with pistol membership $80

Family with two pistol members $180

Full Name of Family member

Date of Birth.

day

month

year

Licence#

Pistol Licnce

SSAA National Number:

SSAA Branch (Q-??) on card

Name, DOB, Licence # of additional family members

Payment

Once you submit the form you will be taken to the payment page

By submitting this application you are certifying that:

I am a fit and proper person to be legally eligible to apply for or be the holder of a Weapons Licence issued in Queensland or elsewhere.

I certify that I am not a member of any organisation which may have as any part of its program the overthrow of the Government by force or violence.

This application for membership is made in full recognition of the Associations requirement for responsible and ethical behaviour. I undertake to do all in my power to preserve the good image of the sport and the association. I understand that if I or any others who are attached to my membership break the code of ethics and or Association Regulations – I or they can be subject to suspension or expulsion from the Branch and/or Association.

I have read and understood the conditions of membership*

By submitting this application you also agree to:

RELEASE AND INDEMNITY

To:

Commonwealth of Australia through the Director, Directorate Property Leasing & Acquisitions, Department of Defence (“you”

I/We, the person or persons who have signed this document hereby agree:

To hold you harmless and indemnify you and your servants, agents and contractors and each and every one of them against all actions, claims, suits, costs, expenses, demands and damages (whether in respect of damages to or loss of property, personal injury or death or otherwise and including all legal costs and other expenses suffered or incurred by you or your servants, agents or contractors) which any person or company may at any time have or may bring or claim or, but for the execution of this document might have been brought, made or claimed against you or your servants, agents or contractors and any one or more of them by reason of or in respect of any matter whatsoever arising out of or caused or aggravated by my or our use of the Property described in the Schedule below (“Property”) or arising out of any action or failure on my part or our part.

That you shall under no circumstances be liable or responsible in any manner whatsoever for my loss, accident, damage or injury to me or us or to any servant, agent, contractor, visitor or invitee of ours which may happen within the Property from any cause whatsoever and also on the express condition that you shall not incur or under any liability to me or us or to my servant, agent, contractor, visitor or invitee of mine or ours for any loss, damage or injury to or in respect of any property of mine or ours or our servants, agents, contractors, visitors or invitees left or deposited on the Property.

SCHEDULE

Property: The firing range situated at Mt Isa Rifle Range, Barkly Highway, Mt Isa North QLD

I have read and understood the ADF Indemnity.*

Payment

Once you submit the form you will be taken to the payment page

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