of 2

Individual Membership Application: International Defensive Pistol Association

Published on 5 days ago | Categories: Documents | Downloads: 0 | Comments: 0

Comments

Content

 

 

International Defensive Pistol Association

Individual Membership Application  First Name

Last Name

Email Address

Circle Here

Yes

May we contact you via email?

Circle Here

Yes 

Members can view and search for me via my city, state and country.  Country

Street Address Line 1

Street Address Line 2

City

State

Date of Birth Month

Day

Select Month

Zip Code

Active Military? Year

Circle Here

Circle Here

Circle Here

Yes 

No 

Male 

Female 

Select Day

Primary Phone

Gender

Circle Here

Alternate Phone

Type of membership applying for:

Membership

American

Foreign* 

1 Year

$40

$60

3 Year

$105

$165

Fax Number

 Membership dues listed on our website at www.idpa.com  supersede all published published information. 

*Foreign membership dues are to be paid by credit card only.

 

Payment may be made by check, money order, Visa, MasterCard, Discover or American Express. All returned checks will have a $25 service charge applied. 

 M y signa  My signatture on this applica licattion ce cerr ti fi fie es tha hatt I may le lega gally lly posse ssess fi fire rea arm rmss and tha hatt I wi ll no nott use use any ski skill ll I lea lear n w whi hile le par tici ticip pating i n I D P A event ventss for any illega illegall ac activity. tivity. Note: IDPA allows junior members ages 12 - 21 as long as their parent or legal guardian signs their membership application and waiver with them and there is another person as the witness.

This application will NOT be processed unless completely filled out, signed and accompanied by a waiver that is signed and witnessed, regardless of age. MEMBERSHIP APPLICANT SIGNATURE: ____________________________________________

Parent or Legal Guardian Signature:_______________________________________________________  for Applicants under 21 years of of age only Bill Wilson, President John Sayle, Vice-President Joyce Wilson, Treasurer 2232 CR 719, 719, Berryville, Berryville, AR 72616 Phone: 870-545-3886 Fax: 870-545-3894 www.idpa.com

Clear

 

 

International Defensive Pistol Association In consideration of THE INTERNATIONAL DEFENSIVE PISTOL ASSOCIATION, a Delaware corporation, permitting me to become a dues-paying affiliate (member) of that corporation and in consideration of that corporation permitting me to engage in the firearms shooting activities of that corporation wherever the same are held in the United States or Internationally, I, on my own behalf and on behalf of my heirs, representatives, administrators and assigns, hereby waive and release any and all claims, demands, causes of action, suits and rights I, or anyone on my behalf, might have against that corporation, its officers and/or directors for personal injury (including death), loss or damage to my property which I (or anyone claiming by or through me) may have against that corporation, its officers and/or directors, as a result of my taking part in the firearms shooting activities sponsored by, sanctioned by or approved by that corporation, its officers and/or directors. Further, I agree that I will not, nor will anyone acting on my behalf claiming by or through me, bring or maintain any suit in Court to assert any claim against that corporation, its officers and/or directors, for any claim that I might have arising out of my participation in any activities sponsored by, sanctioned by or approved by that corporation, its officers and/or directors. I UNDERSTAND THAT ENGAGING IN DEFENSIVE PISTOL SHOOTING SHO OTING ACTIVITIES CONSTITUTES MY INVOLVEMENT ININJURY A VERYOR HAZARDOUS AND DANGEROUS ACTIVITY WITH ACCOMPANYING RISKS OF PERSONAL DEATH AND LOSS OR DAMAGE TO PERSONAL PROPERTY, AND I HEREBY VOLUNTARILY ASSUME THOSE RISKS. I AM OVER TWENTY-ONE (21) YEARS OF AGE. I have read and understand the foregoing provisions of this WAIVER, RELEASE AND COVENANT NOT TO SUE and I have executed this instrument voluntarily on this date. I recognize that the corporation, its officers and directors are not obligated to permit me to participate in any of the corporation's activities and may terminate my participation in such activities at any time and for any reason. The effect of this instrument shall not preclude the prosecution any claim that I might have against persons or corporations other than THE INTERNATIONAL DEFENSIVE PISTOL ASSOCIATION, its officers and/or directors. In other words, I am releasing, waiving my rights and agreeing not to sue THE INTERNATIONAL DEFENSIVE PISTOL ASSOCIATION, its officers and/or and /or directors. This instrument shall remain in full force and effect indefinitely. Applicant Name (Please Print) 

Date

Witness Full Name (Please Print) 

Applicant Address

Applicant Signature

Witness Signature. May be anyone 18 or older  

Parent or Legal Guardian Name -  for Applicants under 21 years of age only  only   -- (Please Print) 

Parent or Legal Guardian Signature -  for Applicants under 21 years of age only  

Bill Wilson, President John Sayle, Vice-President Joyce Wilson, Treasurer 2232 CR 719, 719, Berryville, Berryville, AR 72616 Phone: 870-545-3886 Fax: 870-545-3894 www.idpa.com

Sponsor Documents

Hide

Forgot your password?

Or register your new account on INBA.INFO

Hide

Lost your password? Please enter your email address. You will receive a link to create a new password.

Back to log-in

Close