RAPS Membership for year 2008

New: ______  Renewal:  _____

 Black Badge #

___________
First Name: ________________________________  Last Name: ___________________________________
Address:  ________________________________ City/Town: ___________________________________
Postal Code: _________________

 Phone:

_______________

E:Mail:

_________________________
Occupation: _________

Date of Birth:

_________

Place of Birth:

____________
Do you own any handguns?
  Yes      No

Do you have a PAL (Possession and Acquisition Licence)? 
  Yes      No

Do you have a handgun permit?
  Yes      No

Have you ever been charged with any criminal offense in Canada or the USA?  Yes      No
(If yes give details on the reverse side of this form).

Do you have an alcohol or drug related medical history?   Yes      No
 (If yes give details on the reverse side of this form).

*********** ***********

I the above named, hereby apply for membership in the REGINA ASSOCIATION OF PRACTICAL SHOOTERS and agree to abide by the rules of the Club, and will at no time conduct myself in an unlawful or negligent manner in the handling of firearms.

In consideration of the Club accepting me as a Member, I agree to assume all risk of injury to myself and my property and will not hold the Club or any Officer or Member thereof responsible for any injury or damage I may suffer to person or property.

Provided, however, nothing here in before contained shall release from liability any person, whether a Member or not, who personally by his neglect causes me any such injury or damage.

Dated: ___________
__________________________________ _________________________________
Signature of Applicant  Signature of Voucher (new membership)
RAPS Membership Fee: (Oct 01 to Sep 30)

IPSC Regular membership

$65.00

Non-IPSC Regular membership

$25.00

IPSC Family membership

$47.00

-

-

Included with this fee are the following:

****

Included with this fee are the following:

  ****

RAPS Shared of Indoor Range City Tax

$8.00

RAPS Shared of Indoor Range City Tax

$8.00

RAPS Operating expense

$7.00

RAPS Operating expense

$9.25

SPSA membership

$5.00

- -

IPSC/Canada membership

$22.00

- -

DILIGENTIA newsletter

$8.00

- -

IP-SQUEEK newsletter

$7.25

- -

NRA club membership

$3.00

NRA club membership

$3.00

NRA club insurance

$4.75

NRA club insurance

$4.75

Total RAPS membership fee

$65.00

Total RAPS membership fee

$25.00

Date Paid:

____________

Date RAPS card issued:

____________

Date IPSC card issued:

_____________