Membership application only accepted with completed CMSA and memmbership fees worksheet and payment

Name:      __________________________________________________
Address:  __________________________________________________
City/State/Zip:  __________________________________________________
Phone:     __________________________________________________
Email:      __________________________________________________
CMSA Membership

[   ]  CMSA Family Membership          $100
[   ]  CMSA Individual Membership     $70
[   ]  CMSA Associate Membership       $35
[   ]  No CMSA Membership
ATP Membership

[   ]  ATP Family Membership            $45
[   ]  ATP Individual Membership     $35
[   ]  No ATP Membership

Total CMSA Membership Fees Total ATP Membership Fees

Total ATP & CMSA Membership Fees
Membership Dues - carry through the following calendar year if joining after October 1st.
You must join CMSA through a club to qualify for the above stated fees.
** Family is defined as those living in the same household.
Exception: Minor Grandchildren/Nieces/Nephews
I understand that I am participating in a sport which contains dangers, and risks may arise, including, but not limited to, accidental injury, the forces of nature an illness. In consideration of the right to participate in these events and the services provided for me by the Applegate Trail Peacemakers, Cowboy Mounted Shooting Association and its agents, I have and do hereby assume the risks associated with such events.

SIGNATURE: ____________________________________________

                                  Signature of Applicant Required if over 18 years of age / Date

          Signature of Parent/Guardian Required
(if minor is the only Applicant)  _____________________________________
                                    Signature of Applicant Required if over 18 years of age / Date

Please return to:

PO Box 72321
Eugene,OR 97401

Total Paid:

Paid Cash or Check #