Date of Birth:

Membership Type:
Sportsman

Please answer each question with a “Yes” or “No”.

Are you under indictment or information* in any court for a crime punishable by imprisonment for a term exceeding one year? (* A formal accusation of a crime made by a prosecuting attorney, as distinguished from an indictment by a grand jury).
—Please choose an option—YesNo

Have you been convicted in any court of a crime punishable by imprisonment for a term exceeding one year? (Note: a “Yes” answer is necessary if the judge could have given a sentence for more than one year).
—Please choose an option—YesNo

Have you been convicted of a felony, sexual offense, or domestic violence?
—Please choose an option—YesNo

Are you an unlawful user of, or addicted to, marijuana, or any depressant, stimulant, or narcotic drug, or any other controlled substance?
—Please choose an option—YesNo

Have you ever been adjudicated mentally defective or have you ever been committed to a mental institution?
—Please choose an option—YesNo

Have you been discharged from the Armed Forces under dishonorable discharge conditions?
—Please choose an option—YesNo

Are you an alien illegally in the United States?
—Please choose an option—YesNo

Are you a person who, having been a citizen for the United States, has renounced his/her citizenship?
—Please choose an option—YesNo

Have you ever had any hunting or fishing violations?
—Please choose an option—YesNo

Do you give permission for any photos taken of yourself and/or family members to be published on the website?
—Please choose an option—YesNo

All applicants must be recommended by a member in good standing. Please list the name of the Current club member who is recommending you for membership. All new members must attend an orientation prior to gaining access to the ranges.

Recommended by:

Date of recommendation:

By signing below, I certify that I have read and agree with the Grounds Operating and Use Rules of the Wadsworth Hunt Club:

WADSWORTH DISTRICT CONSERVATION LEAGUE and WADSWORTH HUNT CLUB
GENERAL RELEASE AND WAIVER
Enacted January 1, 2018

Whereas, in consideration of being permitted to attend a course involving firearms/archery, for the instruction in the use and safety of firearms/archery, and for the use of the owned, leased and/or borrowed land/properties (hereinafter the “Premises”) for the above purposes and including, but not limited to, range practice and hunting, and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Undersigned agrees as follows:

Undersigned agrees to indemnify, hold harmless and defend the Wadsworth District Conservation League ( “WDCL”) and the Wadsworth Hunt Club (“WHC”), and the respective directors, officers, volunteers, employees, agents and affiliates from any and all fault, liabilities, cost, expenses, claims, demands or lawsuits arising out of, related to or connected with: Undersigned’s presence at and/or participation in the course of instruction; the discharge of firearms or use of archery equipment by the Undersigned, the Undersigned’s presence on or use of the ranges, buildings, and/or Premises for any purpose; for any and all acts or omissions of Undersigned, and any damages arising from the Undersigned’s presence at and/or participation, including injuries to property, personal injuries or death to others caused by the Undersigned, whether or not as a result of the participation and use of firearms or archery equipment, the facilities and Premises, and regardless of whether such injuries result, in whole or in part, from the negligence of the League. Undersigned furthermore waives for himself/herself and for his/her guests, executors, personal representatives,
administrators, assignees, heirs and next of kin, any and all rights and claims for damages, losses, demands and any other actions or claims whatsoever, which he/she may have or which may arise against the League, including but not limited to, the death of the Undersigned and/or any and all injuries, damages or illnesses suffered by Undersigned or Undersigned’s personal property (whether or not entrusted to the League); which may, in any way whatsoever, arise out of, be related to or connected with: the pursuit of firearms/archery instruction, range practice, hunting or other use of the Premises; and/or the discharge of firearms/archery products. The League shall not be liable for, and the Undersigned, on behalf of himself/herself and on behalf of his/her executors, personal representatives, administrators, assignees, heirs,
and next of kin, hereby expressly releases the League from any and all such claims and liabilities regardless of whether such injuries result, in whole or in part, from the negligence of the League.

Undersigned understands and acknowledges that the handling and discharge of firearms and use of archery equipment is inherently dangerous activity and hereby expressly assumes the risk of taking part in the course for instruction in use and safety of firearms/archery equipment and taking part in the activities on the Premises, which
include, but are not limited to, instruction in the use of firearms/archery equipment, the discharge of firearms/archery equipment, the firing of live ammunition/arrows/bolts, and hunting therewith.

Undersigned hereby acknowledges and agrees that Undersigned has read this instrument and understands its terms and is executing this instrument voluntarily. Undersigned, furthermore, hereby acknowledges and agrees that he/she has read, understands and will at all times abide by all range rules and procedures including the WDCL and WHC Ground Operating and Use Rules, and any other rules and procedures established both orally or in writing by the WDCL and WHC, as well as, the laws of the State of Ohio.

Undersigned expressly agrees that this instrument is intended to be as broad and inclusive as permitted by law, and that if any provision of this instrument is held invalid or otherwise unenforceable, the enforceability of the remaining provisions shall not be impaired thereby. No remedy conferred by any of the specific provisions of this instrument is intended to be exclusive of any other remedy, and each and every remedy shall be cumulative and shall be in addition to every other remedy now or hereafter existing at law or in equity or by statute or otherwise. The election of any one or more remedies hereunder by the WDCL and/or WHC shall not constitute any waiver of WDCL or WHC’s right to pursue other available remedies. This instrument is binding upon the Undersigned and his/her executors, personal representatives, administrators, assignees, heirs and next of kin.