JOIN US | X-Ring Rangers | Junior Air Rifle Club

JOIN US

COMPLETE OUR APPLICATION FORMS

To apply for membership in the X-Ring Rangers Junior Air Rifle Club, please complete all required forms below.

Once your application is reviewed and approved:

We will notify you via email about your application and provide instructions to access your parent panel and manage your membership.

Already approved to join?

Create a Parent Account

FORM 1: Membership Application

Applicant Last Name*

Applicant First Name*

Applicant Middle Initial

Applicant Street Address*

Applicant Apartment No.

Applicant City*

Applicant State*

Applicant Zip/Postal Code*

Is the above address for one or both parents/guardians? One or both boxes may be checked.*

The above address is same as father/guardian.

The above address is same as mother/guardian.

Applicant Date of Birth*

Applicant Age*

Is the applicant a member of the National Rifle Association or USA Shooting?*

Yes

If yes, please provide membership number(s).

Has the applicant had any previous shooting experience or training?*

Yes

If yes, please list experience.

Are either of the applicant's parents or guardians veterans of military service?*

Yes

If yes, are they members of the American Legion?

Yes

FORM 2: Medical History

Applicant Last Name*

Applicant First Name*

Applicant Middle Initial

Applicant Date of Birth*

Phone*

Applicant Street Address*

Applicant City*

State*

Zip/Postal Code*

Emergency Contact Person

Emergency Contact Name*

Relationship to Participant*

Phone*

Emergency Contact Street Address*

Emergency Contact City*

State*

Zip/Postal Code*

Medical Insurance Information

Medical Insurance Company*

Medical Insurance Policy Number*

Insurance Co. Phone Number*

Medical History Information

To be completed by parent or legal guardian.

Please check "YES" or "NO" and provide details where requested. All information will be kept CONFIDENTIAL.

Are you allergic to any medication (including aspirin, penicillin, sulfa. etc.)?*

Yes

List any allergies you have. If NONE, indicate "NONE."*

Do you take any prescribed medications on a permanent or semi-permanent basis?*

Yes

List any medications and give reason. In NONE, indicate none.*

Have you ever been told by a doctor that you have epilepsy?*

Yes

Have you ever had an epileptic seizure?*

Yes

Have you ever been treated for diabetes?*

Yes

Have you ever been told by a doctor that you were anemic?*

Yes

Have you ever been told by a doctor that you have sickle cell anemia?*

Yes

Do you have or have you had high blood pressure?*

Yes

Do you have or have you had heart disease?*

Yes

Do you have or have you had lung disease?*

Yes

Do you have or have you had kidney disease?*

Yes

Do you have or have you had liver disease?*

Yes

Have you ever been told by a doctor that you have asthma?*

Yes

Have you ever had a hernia or "rupture?"*

Yes

If yes, has the hernia or "rupture" been repaired?

Yes

Have been "knocked out" (unconscious) in the past three years?*

Yes

If yes, list the dates.

Have you had a concussion or other head injury in the past three years?*

Yes

If yes, list the dates.

Have you ever been hospitalized overnight due to a head injury?*

Yes

If yes, list the dates.

Is/Are there any special accommodation(s) needed?*

Yes

If yes, please list.

Parent or Legal Guardian Information

Parent/Guardian Last Name*

Parent/Guardian First Name*

Parent/Guardian Email*

Parent/Guardian Mobile Phone*

Signatures

Signature of child applicant.*

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Signature of Parent or Legal Guardian.*

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FORM 3: Liability and Medical Release

Liability and Medical Release

Applicant's First Name*

Parent or Guardian First Name*

Parent or Guardian Last Name*

Read the following paragraph then acknowledge and provide your electronic signature in the next section.

If I am injured or suffer illness or disease while participating in the programs of the X-Ring Rangers Junior Air Rifle Club, except as may be caused by the gross negligence or reckless conduct of the Rifle Club, I and my parent(s) or guardian(s) waive any legal claim against the X-Ring Rangers Junior Air Rifle Club and its affilliating American Legion Post. If injured while traveling to or from any X-Ring Rangers Junior Air Rifle Club activity by public, private or any other means of conveyance, I agree to waive any legal claims against the X-Ring Rangers Junior Air Rifle Club, it leaders, and its sponsors.

I give consent for the X-Ring Rangers Junior Air Rifle Club to provide medical attention, transportation, and emergency medical services as warranted by the circumstances.

I state that I am in good physical condition and I am not aware of any disease or injury that would be aggravated or result in my being incapacitated or injured during any program participation.

I futher understand and agree to abide by the general rules of conduct prescribed for members of the X-Ring Rangers Junior Air Rifle Club and that violations may result in denial of privileges and a forfeiture of all fees paid.

Add your text

I have read this release and understand that it affects my legal rights and responsibilities, and I hereby agree to its terms and conditions. (Check the box to acknowledge this statement.)

Applicant Signature*

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Parent/Guardian Signature*

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For club members under 18, parent(s) or guardian(s) must sign the statement below.

I have explained to my son/daughter the aforementioned stipulated conditions and their ramifications and I further consent to his/her membership in the X-Ring Rangers Junior Air Rifle Club. As his parent/guardian, I understand the terms of this release and and hereby waive any claim(s) set forth herein. (Check the box to acknowledge this statement.)

Parent/Guardian Signature*

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Typed Full Name of Parent/Guardian*

FORM 4: Consent and Release

Release and Consent

Applicant's First Name*

Parent or Guardian First Name*

Parent or Guardian Last Name*

Read the following paragraph then acknowledge and provide your electronic signature in the next section.

I hereby expressly grant to the X-Ring Rangers Junior Air Rifle Club and the American Legion Department of Alabama and their volunteers and employees, agents and assigns, the right to film, videotape, or photograph me and use my picture, silhouette and other reproductions of my physical likeness (as the same may appear in any still camera photograph and/or motion picture file and/or interactive media/internet), in and in connection with the exhibition theatrically on television, or otherwise. I further understand there will be no monetary compensation paid to me for said filming and any promotional materials, which may be derived from the same.

I have read this document and discussed it with my parents or guardians and freely enter this contract. (Check the box to acknowledge this statement.)

Applicant Signature*

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Parent/Guardian Signature*

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Parent/Guardian Affirmation

I, the undersigned, hereby warrant that I am the parent or guardian of the minor listed in Section 1 of this form and have full authority to authorize the above release which I have read and approved. (Check the box to acknowledge this statement.)

I hereby release the X-Ring Rangers Junior Air Rifle Club and The American Legion Department of Alabama, and their volunteers and employees, and their respective licensees, successors and assigns, from and against all liability arising out of the releaser's picture, silhouette and other reproductions of his/her physical likeness in connection with any print, film, interactive media/internet or videotape advertisement or other promotional media. (Check the box to acknowledge this statement.)

Parent/Guardian Signature*

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Typed Full Name of Parent/Guardian*

JINIOR AIR

RIFLE CLUB

COMPLETE OUR APPLICATION FORMS

FORM 1: Membership Application

FORM 2: Medical History

Emergency Contact Person

Medical Insurance Information

Medical History Information

Parent or Legal Guardian Information

Signatures

FORM 3: Liability and Medical Release

Liability and Medical Release

FORM 4: Consent and Release

Release and Consent