Teller County Shooting Society (TCSS) www.tcss-co.org Application Instructions: Revised 25 January, 2019 1. Please fill in all the blanks on the application that apply. 2. Include your NRA membership number and expiration date. Please include a copy of your NRA card or a label from an NRA magazine received as a direct result of your membership. 3. List any Associates (spouse, children under 18) that you would like on your membership. Please list individual names and dates of birth. 4. Be sure to sign your application. 5. See the payment worksheet for initiation fee waiver and pro-rating of general membership dues if applicable. Include a copy of your waiver credentials as required. 6. Review and sign the GCSSC Liability Release & Waiver. 7. Include your check for the initiation fee and full payment of dues for the level of membership you have selected. 8. Please make a copy of your completed application, NRA verification, liability waiver, and your payment for your files. 9. Send all documents to. 10. Upon receipt, the Board of Directors (BoD) will review your application and, when the decision has been made, you will be notified. If accepted, you will be added to the membership E-Mail distribution list and thereby notified of all membership meetings, club events, and other pertinent information. Thank you for your interest in the Teller County Shooting Society! For any further membership information or questions about the application process, please contact our Membership Secretary using the contact information available on the TCSS website: www.tcss-co.org
Revised 25 January, 2019 Teller County Shooting Society (TCSS) www.tcss-co.org DATE: Last Name: First Name: M.I.: Date of Birth: Sex: M F Mailing Address: City: State: ZIP: Home Phone: Business Phone: Mobile Phone: E-Mail: NRA Membership #: Expiration Date: (Proof of NRA membership is required within two months of this application s date per Article III, Section F of the Teller County Shooting Society By-laws.) Please list any associates to be included in this membership here. An associate is a spouse or child less than 18 years of age of the primary member. Name Relation (circle one) Date of Birth I am applying for the following TCSS membership category. Please check only one. See payment worksheet for waiver of initiation fee and pro-rating of general memberships. General: An initiation fee of $200 plus $150 dues with application. Annual dues and one guest per month. Bronze: An initiation fee of $200 plus $500 dues with application. No annual dues for five years. Silver: An initiation fee of $200 plus $800 dues with application. No annual dues for ten years. Gold: An initiation fee of $200 plus $1,400 dues with application. No annual dues for fifteen years. Platinum: An initiation fee of $200 plus $1,800 dues with application. No annual dues for life of applicant. I certify that I am a citizen or legal resident of the United States of America; that I am not prohibited from possessing a firearm under the laws of the United States or the State of Colorado; and that, if admitted to membership, I will fulfill the obligations of good sportsmanship and citizenship and abide fully with the By-Laws and Range Rules of the TCSS. Signature: Board Member Authentication:
Revised 25 January, 2019 Teller County Shooting Society (TCSS) www.tcss-co.org Payment Worksheet: Description Price Initiation Fee: Members of the U.S. Armed Services on active duty, honorably discharged veterans of the U.S. Armed Services, retired members of U.S. law enforcement, retired U.S. firefighters, or CC&V Employees (please provide supporting documents) $ 0.00 All Others $ 200.00 Membership Dues General Membership Received 1/1 2/28 Received 3/1 6/1 $ 150.00 $ 112.50 Received 6/2 9/1 $ 75.00 Received 9/2 12/31 $ 37.50 Bronze Membership $ 500.00 Silver Membership $ 800.00 Gold Membership $1,400.00 Platinum Membership $1,800.00 Total Included: Note: Initiation fees and dues are NOT refundable once accepted as a member of TCSS. Please be aware that the TCSS is a volunteer organization and in order to continue our build out of the range and staff events we need members to pitch in and help out on a variety of projects. Below, please indicate what skills and/or volunteer time you may be able to provide and/or on which projects you would like to be involved: Carpentry General Construction Special events Painting Asphalt/concrete Sight-in days General labor Light/heavy equipment Donation of building materials Becoming a NRA Range Safety Officer Other (describe) Answering the questions below is optional: Do you currently hold any NRA certified instructor credentials? Yes No If yes, which one(s)? How did you hear about us? Newspaper Event Drive by sign Mail/Store/Flyer Internet/Website Referral (Who?) Which of the following interests you? Handgun Rifle Shotgun Training/Instruction Hunter Education Shooting Competition Other Have you completed any NRA instructional programs? Yes No If yes, which one(s)?
Teller County Shooting Society (TCSS) www.tcss-co.org Gold Camp Shooting Sports Center Liability Release and Waiver Revised 25 January, 2019 I. Intent and Purpose Teller County Shooting Society, Inc., a Colorado non-profit corporation ( TCSS ) owns and operates the Gold Camp Shooting Sports Center in Teller County, Colorado ( GCSSC ). The GCSSC provides a venue for outdoor shooting sports to its members including, but not limited to, handgun and rifle ranges, skeet and trap ranges and archery ranges. As a prior condition to using the GCSSC facilities, all members and their guests are required to read and sign this Liability Release & Waiver, which releases the TCSS and its affiliates, subsidiaries, partners, officers, directors, employees, and agents from any and all claims for mental/physical, bodily injuries or other damages resulting from or incidental to a member s or guest s use of the GCSSC facilities and participation in activities on GCSSC property. Any member or guest who elects not to sign this Liability Release & Waiver is prohibited from entering the GCSSC property and from using the GCSSC facilities. WHEREFORE,, a Member of TCSS, or Guest of, in consideration of being permitted entry to and/or use of the GCSSC property and facilities for whatever purpose including, but not limited to, use of firearms and/or other weapons by him/her including, but not limited to, crossbows and long bows, and with full knowledge that firearms and/or other weapons are used and discharged on the GCSSC property, the Member/Guest agrees as follows: II. Assumption of Risk Member/Guest understands that engaging in or being present during shooting sports is an inherently dangerous activity, and that certain risks and dangers may occur in connection with activities at the GCSSC. Member/Guest, on behalf of himself or herself, and his/her heirs, representatives, successors, and assigns, hereby releases and forever discharges TCSS and its affiliates, subsidiaries, partners, officers, directors, employees, and agents from any and all liability or claims which Member/Guest may incur as a results of death, loss, injury, or damage which may be incurred while engaged in any activities on the GCSSC property, and hereby states that he/she affirmatively assumes any and all risks attendant with the above activities. Among the risks are the following: (1) the nature of the activity itself; (2) the acts or omissions, negligence in any degree, of any other person present at the GCSSC; (3) apparent defects or conditions in equipment or property supplied by TCSS, the GCSSC, or other persons or entities; (5) acts of the Member/Guest, his/her agents or guests, or other participants in any activity; (6) the physical condition of the Member/Guest and his/her agents or guests, or their own acts or omissions; (7) first aid, emergency treatment or other services rendered by any person; (8) absence of any Range Safety Officer ( RSO ) or supervisor of any activities; and, (9) the absence of, misuse of, or defect in any life-saving equipment. The Member/Guest understands and acknowledges the before mentioned list is not complete or exhaustive and that other risks known or unknown, identified or unidentified, anticipated or unanticipated may also result in injury, death, illness, disease, or damage. The Member/Guest expressly accepts those risks not specifically listed before as well. III. Release and Indemnity The Member/Guest herby voluntarily releases and forever discharges TCSS and its affiliates, subsidiaries, partners, officers, directors, employees, and agents from any and all liability, claims, demands, actions or rights of action which are related to, arise out of, or are in any way connected with Member s/guest s and his/her agents and guests use of the GCSSC, and for any and all injury, death, illness, disease or damage to Member/Guest and hi/her agents and guests. Member/Guest
Revised 25 January, 2019 Teller County Shooting Society (TCSS) www.tcss-co.org further agrees, promises, and covenants to hold harmless, defend and indemnify TCSS and its affiliates, subsidiaries, partners, officers, directors, employees, and agents from any and all loss, liability, cost, claims, demand and expense (including reasonable attorney s fees and litigation costs at trial, on appeal or in settlement) and from any other costs incurred in connection with claims for Member Initials Guest Initials bodily injury, loss of life or property, damage to the Member/Guest or is/her agents or guests, or which the Member/Guest or hi/her agents or guests may negligently or intentionally cause to anyone in the course of their use of the GCSSC. IV. Covenant Not to Sue Member/Guest further agrees, promises, and covenants not to sue, assert or otherwise maintain or assert any claim against TCSS or its affiliates, subsidiaries, partners, officers, directors, employees, and agents for any injury, death, illness, disease, or damage or which the Member/Guest has assumed the risk pursuant to Article III above, or for which the Member/Guest has agreed to release and indemnify pursuant to this Liability & Release/Waiver. In signing this document, the Member/Guest fully recognizes that, except as otherwise provided herein or at law or equity, if anyone if hurt on property, is damaged while Member/Guest is engaged in use of the GCSSC, he/she will have no right to make a claim or file a lawsuit against TCSS or its affiliates, subsidiaries, partners, officers, directors, employees, and agents. Member/Guest understands and acknowledges that by signing this document he/she has given up certain legal rights and/or possible claims which he/she might otherwise assert or maintain against TCSS or its affiliates, subsidiaries, partners, officers, directors, employees, and agents or other persons or entities. The Member/Guest understands and acknowledges that, except as otherwise provided herein or at law or equity, by signing this document he/she has assumed responsibility and legal liability for the claims or other legal demands, including defense costs, which may be asserted by his/her agents and/or guests against him/her as a result of their use of the GCSSC. TCSS has adopted the Gold Camp Shooting Sports Center Rules to ensure a safe, accident-free shooting environment and to ensure an enjoyable experience for its members and their guests. All members and guests are required to follow those Rules at all times which on the GCSSC property. TCSS reserves the right, in its sole discretion, to modify those Rules at any time. The undersigned agrees to abide by all such rules and regulations as adopted by TCSS from time to time. Member/Guest expressly agrees that this Liability Release & Waiver is intended to be as broad ad inclusive as permitted by law and that if any provision of this Liability Release & Waiver is held invalid or otherwise unenforceable, the enforceability of the remaining provisions shall not be impaired. No remedy conferred by any of the specific provisions of this Liability Release & Waiver is intended to be exclusive of any other remedy, and each and every remedy shall be cumulative and shall be in addition to every other remedy now or hereafter existing at law or in equity or by statute or otherwise. The election of any one or more remedy hereunder by TCSS shall not constitute any waiver of TCSS s right to pursue other available remedies. This agreement binds the Member/Guest and his/her heirs, next of kin, assignees, personal representatives, administrators, and executors. THIS MEMBER/GUEST AFFIRMATIVELY STATES THAT HE/SHE IS UNDER NO DURESS OR UNDUE INFLUENCE AND IS SIGNING THIS LIABILITY RELEAES & WAIVER OF HIS/HER OWN FREE WILL, AND THAT HE/SHE HAS READ AND FULLY UNDERSTANDS ALL OF THE TERMS CONTAINED HEREIN. If a Guest is signing, the sponsoring Member must also sign.
Teller County Shooting Society (TCSS) www.tcss-co.org Revised 25 January, 2019 Member or Associate Signature Guest Signature Print Name Date Print Name Date