Membership Form - Josephine County Sportsman Association Sportsman Park

Type of Membership*
- Single
- Family
- Junior (under age 19)
Name*
First Last
Your Date of Birth
Date Format: MM slash DD slash YYYY

Required if under 19 Yrs old.
Address*
Street Address City State ZIP Code
Email*

We will follow-up with you about completing your membership by this email address.
Phone*
NRA Member
- Yes
- No
Spouse
If applying for Family Membership, please add the name of your spouse.
Additional Family Members
Name Date of Birth

If applying for Family Membership, please list names of your children.
Waiver Acknowledgement*
- I have printed/downloaded the waiver (link below) and understand that I need to submit it with my membership information to finalize.
Email
This field is for validation purposes and should be left unchanged.

Name	Date of Birth