NEW HAMPSHIRE COWBOY MOUNTED SHOOTERS

2007 MEMBERSHIP APPLICATION

New   ______ Renewal ______ NHCMS#________CMSA# __________ SASS # _________

Mens ________  Ladies ________  Junior ________    Senior ________    Wrangler ________

Name____________________________________________Date of Birth ________________

Address ____________________________________________________________________

Town  _____________________________     State____________  Zip __________________

Phone   ( ___)__________      Cell  ( ___  )______________ email ______________________

 Individual Membership: $25.00 _____          Junior Member 12-16: $15.00  _____

Wrangler u/12: $15.00 _____      Associate Member: $15.00 _____

Family Membership: $40.00 _____

* Please fill in separate form for each family member

As a member you will receive a newsletter and match results, plus advance notice of upcoming
shoots. You are able to vote at club meetings. You will enjoy the sport and help promote gun
safety as well as being part of a family sport.

Family Membership  Those persons living under the same roof in a spousal relationship and/or their
children under the age of 21 who are still enrolled full time in school.

For more information contact:
Dick Moody PO Box 148 New Boston, NH 03070
(603) 487-3379 email: Rmoody 3415@aol.com

Liability Release Form

I understand that I am participating in a sport, which contains dangers, and risks may arise, including, but not limited to, accidental injury, the forces of
nature and illness. In consideration of the right to participate in these events and the services provided for me by the New Hampshire Cowboy Mounted
Shooters or Cowboy Mounted Shooting Association and its agents, I have and do hereby assume the risks associated with such events. The contestant
shall at his own expense, defend management and/or all sponsors, their members, or employees from any and all such claims and indemnify, from any and
all liability, damage and costs arising from injuries to person or property occasioned by any act or omission of the contestant.

Signature of Applicant Required  _________________________________  Date ___________

Parent/Guardian if under18 _____________________________________  Date ___________

MAIL TO:   Betsy Moody                                         Rmoody3415@aol.com
                    PO Box 148
                    New Boston, NH 03070                        (603) 487-3379