Application for Membership in the

Lone Star Frontier Shooting Club

Affiliated with the NRA, TSRA and the Single Action Shooting Society

 Please mail the completed and                        

signed application with dues to:                            4147 Rench Road     Ft. Worth, TX  76135      

 Membership Dues

Life Membership:                                $200                                                               

Annual Membership:                           $30 per year (pro-rated monthly)

Associate or Junior Membership:         $15 per year  (Immediate Family Member; Same Residence)

Family Maximum                                 $50 per year

   I fully understand and acknowledge that; (a) risks and dangers exist in my participation in these activities; (b) my participation in such activities may result in my injury or illness including but not limited to bodily injury, disease strains, fractures, partial and/or total paralysis, eye injury, blindness, heat stroke, heart attack, death or other ailments that could cause serious disability; (c) these risks and dangers may be caused by the negligence of the land owners, employees, officers of Lone Star Frontier Shooting Club or agents of Ormsby Ranch, the negligence of the participants, the negligence of others, accidents, breaches of contract, the forces of nature or other causes. These risks and dangers may arise from foreseeable or unforeseeable causes; and (d) by my participation in these activities I hereby assume all risks and dangers and all responsibility for any losses and/or damages, whether caused in whole or in part by the negligence or other conduct of the land owners, agents, officers of Lone Star Frontier Shooting Club, or employees of Ormsby Ranch.

  I, on behalf of myself, my personal representatives and my heirs, hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify the land owners, agents, officers of Lone Star Frontier Shooting Club and employees of Ormsby Ranch from any and all claims, actions or losses for bodily injury, property damage, wrongful death, loss of services or otherwise which may arise out of my participation in these activities, I specifically understand that I am releasing, discharging and waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct by the land owners, agents, officers of Lone Star Frontier Shooting Club or employees of Ormsby Ranch.

  I HAVE READ THE ABOVE WAIVER AND RELEASE AND BY SIGNING IT AGREE IT IS MY INTENTION TO EXEMPT AND RELIEVE FLOYD ORMSBY, THE ORMSBY FAMILY, ANY EMPLOYEES OF THE ORMSBY RANCH AND THE OFFICERS OF LONE STAR FRONTIER SHOOTING CLUB FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE.

  _________________________________                _________________________________

Printed Name                                                                           Emergency Contact Person

______________________________________                   ______________________________________

Signature                                                                                  Emergency Contact Address or Phone

 ______________________________________                   ______________________________________

Street or Mailing Address                                                                       Signature of Parent or Guardian (if under 18)

 ______________________________________                  

 City, State & Zip                                                                  

 ______________        ______________                                _________________________________

Home Phone                Work or Cell Phone                           Email Address (not required)

 ____________              ____________              ___________              ____________________________

NRA #                                     TSRA #                      SASS #                                  SASS Alias

 ______________________________________                          ______________________________________

Executive Officer                                Date                             Secretary/Treasurer                              Date