Date: September, 25 2022

I hereby declare that I possess a valid Restricted PAL license.

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Have you ever been or are you currently a member of another gun club?
Do you possess restricted fire arms at this time?
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I hereby declare that I understand the application and instructions and that the information provided by me in this application is true and correct and to the best of my knowledge. Further, I understand that to make a false or misleading statement(s), either orally or in writing, when applying for membership will result in denial of acceptance for membership with the Wentworth Shooting Sports Club.

Loss of Deposit for Failure to Attend Club Safety Course

I hereby agree to attend the Club Safety Course at the given date and time as scheduled by the Safety Course Coordinator. I further hereby agree to give a minimum of 24 hours notice in the event that I am unable to attend my scheduled Safety Course. I fully understand that failure to attend the Safety Course, or notify the proper parties of my absence from the course can result in the loss of my payment.

This information will be used for the sole purpose of evaluating your candidacy. The club will not share, rent or sell any of the information collected to any third party.
* Wentworth Shooting Sports Club reserves the right to request personal references at any time.