| Acord Mountain Sportsman's Club Application and Liability Forms P.O. Box 1331 Beckley WV. 25802 |
| Application: 1. Name: LAST________________ FIRST_______________ MI._______ 2. Address: Street:_____________________ Apt#:________________ City:_______________________ State:________________ Zip Code:_______________ 3. Home Phone 1:________-__________-_________ 4. Alternate Phone:_______-________-__________ 5. Work Phone:_______-_________-_________ 6. Emergency Phone #:________-________-_________ 7. Fax Number (If Applicable):_________-________-_________ 8. Email Address: ___________________ 9. References (If Applicable include Names and Phone Numbers): _________________________________________________________________________________________ 10. How many people are joining with you?_______________ (Each individual must complete this form) 11. Tell us how you found out about our club?_______________________________________________ 12. How many days (approximately) do plan to hunt at our club?_________________________________ 13. Do you feel your an avid or respectable hunter?______________________ 14. Are you a West Virginia resident, if so what county do you reside in?____________________________ 15. If asked would you volunteer helping out around the club property, ie. planting food plots ect.? __________________________________________________________________________________________ __________________________________________________________________________________________ 16. If you would like to have your birthday or anniversary announced in our newsletter please include the dates here._____________________________________________________________________________ __________________________________________________________________________________________ |
| Hunting Terms and Conditions: *All persons hunting will carry an ID Card (IE. Drivers License, Military ID Card ect.) with membership card. *Members must use premises in a safe manner: NO alcoholic beverages or controlled substances (Illegal Narcotics) allowed on premises, on person, or consumed before hunting on this land. Individuals caught under the influence will no longer be able to be a member. Thier club dues will not be refunded. *All members are required to respect this land, NO Littering, Waste, or Dumping allowed. This includes but isn't limited to dumping carcasses of any game taken. *All vehicular traffic (Pick-up's and cars) limited to existing improved roads. ATV's allowed under these circumstances: Safe speeds required, no horseplaying while riding, Helmets required, ATV's are restricted to safe trails that minimize impact and erosion on club property. *West Virginia hunting license for all members/guest's are required by West Virginia law. *Premises may be closed to members during extreme dry weather without notice, due to fire hazards. *No permanent hunting stands allowed to be contructed. Self-climbing stands are allowed. NO nails or climbing spikes can be used with hunting stands. Fixed stands allowed with portable climbing ladder. *NO hunting with dogs allowed on club property. NO Spotlighting or poaching. *NO trapping or furbearers allowed. NO bucks taken under 6 points total. NO jake turkeys harvested. -As a member I have read the above hunting terms and agree to uphold these terms. I acknowledge if I do not follow these terms I will have my hunting privilages revoked and further more will not be refunded my dues. I also understand Acord Mtn. Sportsman's Club will not be liable for the following: *Broken or stolen equipment/personal property *Injuries caused by myself or another person whether fatal or otherwise *Detaining anyone whom is trespassing, under the influence, or poaching -I have read the above club hunting terms and conditions and agree to follow all of these regulations. I vow that I will hunt like a respectful hunter at all times and report anything I feel is suspicious to the club president or affiliated administation staff. (MEMBER) _________________________________ (Print LAST, First MI.) __________________________________ (SIGNATURE) Acord Mountain Sportsman's Club President/Land Owner: Gary Acord Acord Mountain Sportsman's Club Administration Staff: Anthony Osborne and Steve Acord Acord Mountain Sportsman's Club Form-3 |
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