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Individual Membership Application: International Defensive Pistol Association

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International Defensive Pistol Association

Individual Membership Application First Name

Last Name

Email Address

Circle Here

 Yes

Circle Here

 Yes

May we contact you via email?

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

Zip Code

Active Military? Year

Circle Here

 Yes Primary Phone

Gender

Circle Here

Circle Here

Circle Here

No

Male

Female

Alternate Phone

Type of membership applying for: Membershi American Foreign* 1 Year

$40

$60

3 Year

$105

$165

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

Fax Number

*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.

 My signature signature on this application application certifies certifies that I may may legally possess possess firearms firearms and tthat hat I will not not use any skill I learn while participating in IDPA events for any illegal activity. 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   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, Berr Berryville, yville, AR AR 72616 Phone: 870-545-3886 Fax: 870-545-3894 www.idpa.com www.idpa.com

 

International Defensive Pistol Association In consideration of THE INTERNATIONAL 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, 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 ACTIVITIES CONSTITUTES MY INVOLVEMENT IN A VERY HAZARDOUS AND DANGEROUS ACTIVITY WITH ACCOMPANYING RISKS OF PERSONAL INJURY OR DEATH AND LOSS OR DAMAGE  TO PERSONAL PROPERTY, PROPERTY, AND I HEREBY VOLUNTARIL VOLUNTARILY Y ASSUME THOSE 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 of this instrument instrument shall not not preclude the the prosecution prosecution any claim that I might have against persons or corporations other than THE INTERNATIONAL DEFENSIVE PISTOL ASSOCIATION, 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 directors.  This instrument instrument shall remain remain in full force force and effect indefinitely. indefinitely. Applicant Name (Please Print)

Date

Witness Full Name (Please Print)

Applicant Address

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

 

International Defensive Pistol Association Applicant Signature

Witness Signature. May be anyone 18 or older

Parent or Legal Guardian Name - for Applicants under 21 years of age 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, Berr Berryville, yville, AR AR 72616 Phone: 870-545-3886 Fax: 870-545-3894 www.idpa.com www.idpa.com

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