Clairton Sportsmen’s Club
Application for Membership
Please print clearly

Name_________________________________________ Age___________ Date of Birth______________

Address_________________________________________________________________

_______________________________________________________________________

Phone________________________________-Email___________________________________________          

Occupation_____________________________________________________________________________

Are you currently on active duty in any U.S. armed service?   Yes          No                                     

 (There are no fees or dues required of active members of the US armed forces) __________________________________________________________________________________

Have you ever been a member of Clairton Sportsmen’s Club?  Yes                  No

Do you belong to any other local sportsmen’s clubs? Yes           No     

 If you answered yes the name of the club to which you belong ___________________________________    

Are you an honorably discharged veteran of any of the U. S. Armed Services?   Yes            No

Dues________    Initiation __N/A__ (initiation waived if any above box is checked yes)                                                                                    

Areas of interest ….. Circle as many as you wish

Pistol       100yd pistol     action pistol      rifle      skeet     trap     archery        3-d archery

________________________________________________________________________

Spouse: Name________________________________________________________ Age________ Date of Birth______________

Address_________________________________________________________________

_______________________________________________________________________

Phone_______________________-Email________________________________________ Dues$__________

Child (under 18): Name _______________________________________________Age________ Date of Birth_________

Address_________________________________________________________________

_______________________________________________________________________

Phone_____________________-Email_________________________________________Dues$_____________

Total received this application  Cash □ _________________  or  Check # □  __________________

I am a citizen of the United States                  Yes □                         No □

Have you ever been convicted of a felony        Yes □                   No □

__________________________________

Signature of Applicant (Please show Identification)

Falsification of information will result in termination of Membership

__________________________________________                       _______________________________________                                                           

Signature of member in good standing                                              Signature  of CSC Director

Application taken by___________________________ Date_______________________

(applicant must sign oath on back of application)

Oath

(must be signed before application can be processed) 

I, _________________________________,    of my own free will and accord, solemnly swear to

                             (Signature)

abide by the By-Laws of the Clairton Sportsmen’s Club, and to assist its officers and members for the betterment of the Club in any way possible.  I agree to submit to the will of the majority of said members first, having their guarantee that there will never be anything derogatory to my morals, my religion, or the laws of my country.  I swear that I will not divulge, except to a member, any of the secrets or business of this Club.  I solemnly swear not to defraud the Club or any member in any way, nor willfully allow any others to do so.  I promise upon my honor to encourage harmony among the members, and oppose all dissension and discord. 

Orientation 

The above named individual has received the required orientation of the CSC facility and rules

pertaining to them on  this day _____________. by _____________________________________

                                                                                                                  Date                                       Signature of person administrating orientation 

Dues Schedule for New Members

* Senior members must first have paid a full year at regular membership rates, with a fractional year not being counted.