Web Page: http://www.upperhumberrodandgun.com
Email: uhrgassoc@gmail.com Funds can be directly deposited to this account
Name: _________________________________________________Date of Birth: _________
Address: ____________________________________________________________________
Postal Code: __________________
Telephone: ____________________________ Cell #: ________________
Email: ________________________________________________________
The student must be enrolled full time in a post-secondary educational institution and be taking
courses towards an academic degree or technical/certificate program. The student must provide
proof of full time enrollment at the time of the membership application or renewal. Please include
one of the following. If you possess firearms or intend to use our ranges you must also include a
photocopy of both sides of your firearms license, as indicated below:
(Indicate your choices) □ Certificate of good conduct (RCMP or RNC) □ Photocopy of both sides
of your valid Firearms License. Membership runs Feb. 01, 2025 to Jan. 31, 2026
□ Firearms License #________________________________ □ Expiry Date______________
Please check your recreational interests: □ Shooting □ Archery □ Hunting □ Fishing
Please check any club volunteer interests: □ Rifle Range □ Trap □ Pistol Range □ Archery
□ Membership □ Club Activities □ Newsletter
STUDENT MEMBERSHIP FEES: (Includes $5,000,000 liability insurance) $57.00 (includes
taxes) annually, payable with application or application processing may be delayed.
Indicate payment type: □ Cash □ Cheque □ Money Order □ Bank Draft
□ Electronic email (send to: uhrgassoc@gmail.com
Application must be completed, signed and dated for processing.
Signed:_______________________________________Date:_______________
Note: By signing this application you acknowledge that you have read the Association’s range
rules and regulations and agree to abide by them. Privacy Statement: All membership application
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 applicant.
HOME OF THE ALL NEWFOUNDLAND BIG GAME TROPHY COMPETITION
2025 STUDENT MEMBERSHIP
UPPER HUMBER ROD AND GUN ASSOCIATION
177 GOOSE ARM ROAD, DEER LAKE, NL A8A 3H9
