Ten X Shooting Club, Inc
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Ten X Shooting Club, Inc. Key Fob #: ______________________
P.O. Box 226, Lancaster, NY 14086
Application for Obtaining KEYS
Last Name:_________________________________________ First Name:_______________________________________________
Main Phone: _____________________________Alt. Phone: _______________________Email: _____________________________
Home Address Number & Street: ________________________________________________________________________________
City: ________________________________________State: ______________________________Zip: ________________________
Mailing address (if different) Number & Street: _____________________________________________________________________
City: ________________________________________State: ______________________________Zip: ________________________
Accepted as Member: ________________________________ Witness: _________________________________________________
(Date) (Signature of Board Member)
Safety Orientation completed:__________________________ Witness: _________________________________________________
(Date) (Signature of Board Member)
Code of Conduct signed: ______________________________Witness: _________________________________________________
(Date) (Signature of Board Member)
Key Holder Fee paid: ________________________________ Witness: _________________________________________________
(Date) (Signature of Treasurer)
BEFORE being issued a Key for any Club facility the prospective Key Holder will have been a Member in Good Standing with the Club for a period of not less than six (6) months.
BEFORE being issued a Key for any Club facility the Club’s Chief Range Officer, Assistant Range Officer and/or their Designee will:
- verify the prospective Key Holder’s knowledge of basic range safety.
- evaluate the prospective Key Holder’s conduct while handling firearms and participating in Club activities.
- ensure that the prospective Key Holder demonstrates his complete understanding of the responsibilities accompanying access to Club facilities including: lights, heat/ventilation, compressors, clean-up, security, acceptable munitions, scheduling obligations, etiquette etc.
There is a FEE due the Club each and every year the Key Holder possesses a key to the Indoor Range. The fee is set by the Board of Directors. Refer to the most recent Schedule of Fees for the current Key Holder fee.
Continued on reverse . . .
Keys are the PROPERTY of the Club.
Keys must be immediately SURRENDERED to the Club if/when demanded by the Club. If a Key is not returned a fee will be due the Club. The fee is set by the Board of Directors. Refer to the most recent Schedule of Fees for the current Key Replacement fee.
Keys must be promptly RETURNED to the Club if/when the Key Holder terminates his Membership with the Club or if/when he no longer wishes to fulfill the obligations of a Key Holder. If a Key is not returned a fee will be due the Club. The fee is set by the Board of Directors. Refer to the most recent Schedule of Fees for the current Key Replacement fee.
If a Key needs to be REPLACED for any reason other than malfunction a fee will be due the Club. The fee is set by the Board of Directors. Refer to the most recent Schedule of Fees for the current Key Replacement fee.
Keys are NOT available to ASSOCIATE Members.
Keys are NOT available to JUNIOR Members.
I, ___________________________________________________, have read and understand this application and certify that the above (Print Name of prospective Key Holder)
information provided by me is true and correct to the best of my knowledge.
APPLICANT’S SIGNATURE: ______________________________________________ DATE:_____________________________
Indoor Range Key issued: ____________________________ Issued by: ________________________________________________
(Date) (Signature of Security Officer)
Outdoor Range Key issued: ___________________________ Issued by: ________________________________________________
(Date) (Signature of Security Officer)
Page 2 of 2 (rev.3/20/13)
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