Web Page: www.upperhumberrodandgun.com Email: uhrgassoc@gmail.com
Name: _______________________________ Date of Birth: ________________________
Address: _________________________________________________________________
Postal Code: _______________Email: _________________________________________
Phone _____________________________ Cell __________________________________
Please include one of the following: If you posses firearms and intend to use the shooting facilities, a
copy of both sides of your firearms license (PAL), or a letter of good conduct from the RCMP or RNC
□ New copy of both sides of your valid Firearms License (PAL) □ Letter of conduct
□ Firearms License #: ______________________________ □ Expiry Date _______________
MEMBERSHIP FEES:• Includes $5,000,000 liability insurance through National Firearms
Association• Payment must be included with the completed application in order not to delay
processing. • Fees include All Taxes.
□ $95 annually if received or post marked between Jan. 01-Sept 30, 2025
□ $65 if received or postmarked between Oct. 01, 2025 to Jan 31, 2026
Membership runs from Feb. 01, 2025 – January 31, 2026 regardless of the date of renewal.
Indicate payment choice □ Cash □ Cheque □ Money Order □ Bank Draft
( no password required) □ Electronic email transfer ( send to: uhrgassoc@gmail.com )
Please indicate your interests. □ Shooting □ Archery □ Hunting □ Fishing
Volunteer interests □ Rifle Range □ Trap □ Pistol Range □ Membership
□ Club Activities □ Newsletter
Privacy Statement: All membership information is confidential and will not be released, except for insurance
coverage purposes and Canadian Firearms Centre requirements, without the signed written consent of the
member.
Form must be completed, signed, and dated for processing (include copy of PAL)
Signed: _________________________________ Date: __________________________
HOME OF THE ALL NEWFOUNDLAND BIG GAME TROPHY COMPETITION
2025 NEW MEMBERSHIP FORM
UPPER HUMBER ROD AND GUN ASSOCIATION
177 GOOSE ARM ROAD, DEER LAKE, NL A8A 3H9
