Home of Suffolk Archers and Bow Hunters

2010-2011 Suffolk Archers Dues Renewal Package

1. Please pick your Dues Package and sign this 2010 Dues Renewal Application. The club collects dues based on a fiscal year running from April 1 to March 31. If you did not complete your work commitment
in 2009, an additional billing will be attached. This must be satisfied before your new 2009 Membership ID card will be issued.

2. The gate lock combination will change on April 1, 2010. All members must renew their annual dues by April 1, 2010, or lose access to the 20-acre facility and Suffolk Archers programs, as well as participation in share ownership points. An additional $25.00 reinstatement fee shall be added to the annual dues of those who wish to renew, but that option is only available prior to member’s receipt of a letter revoking membership due to non-receipt of dues. Once revoked, membership in Suffolk Archers cannot be renewed, and that individual can only join Suffolk Archers as a new member.

3. Please have all members of your immediate family who are eligible for free membership and who may want to shoot at the Suffolk Archers facility sign the new Safety Rules Sheet. Also, please have them
sign the new Waiver/Release or if minors, complete a form on their behalf (make additional copies of this form as necessary). Not complying with this will delay the renewal of your Membership ID card.

4. Complete the fields for address, telephone, and e-mail. Providing your email address is particularly important, as this will be used for emergency notifications, if necessary.

5. All information submitted as part of this Dues Renewal Package is CONFIDENTIAL to Suffolk Archers’ business only, except as noted under the optional Special Permissions (see renewal application).

6. After completion, go back to payment page for online payment.

Feel free to call Jeff Milano at 516 398-0741 if you need further explanation, or have any additional questions related to this Dues Renewal Form.

Personal Information Section
First and Last Name:
Street Address:
Town/City:
State:
Zip Code:
E-mail Address:
Home Phone:
Work Phone:
Cell Phone:
Send club news via email: Yes
Family and Archery Information Section So Suffolk Archers can serve you better, please tell us a little bit about yourself and your family:
Your Occupation
Your Birthday	mm/dd/year
Spouse's Name
Your Spouse's Birthday	mm/dd/year
Will Your Spouse Also Shoot? Yes
First Child's Name
First Child's Birthday	mm/dd/year
Will First Child Also Shoot? Yes
Second Child's Name
Second Child's Birthday	mm/dd/year
Will Second Child Also Shoot? Yes
Third Child's Name
Third Child's Birthday	mm/dd/year
Will Third Child Also Shoot? Yes
Fourth Child's Name
Fourth Child's Birthday	mm/dd/year
Will Fourth Child Also Shoot? Yes
What is Your Experience Level?	Beginner 1-3 Years 4-10 Years 11+ Years
Rank your archery interest on a scale of 1-10 with 10 being the highest:	Target Hunting
What is your equipment preference?	Traditional Compound
Note that Suffolk Archers does not consider crossbows to be archery equipment and crossbows may NOT be used anywhere on club property.
Safety Rules Section
It is the responsibility of the “primary” member to ensure that all family members and guests entering upon the Suffolk Archers facility are familiar with the SAFETY RULES and that they agree to abide by them.
SUFFOLK ARCHERS SAFETY RULES It is the responsibility of the “primary” member to ensure that all family members and guests entering upon the Suffolk Archers facility are familiar with these Safety Rules and that they agree to abide by them. Members of Suffolk Archers and their guests, whenever on the facility including when attending scheduled shoots, shall observe the following range and safety rules to insure the safety of all participants. 1. Absolutely No Broad heads to be shot on the range or practice butts, (Except at the Broad head Pit at the top of the range) 2. No crossbows or firearms will be shot anywhere on the range at any time. 3. Members and Guests, while using the practice butts or out on the range, will not cross or move forward of the shooting line, to retrieve arrows or for any other reason, until all shooting has ceased, and all shooters on the shooting line know and acknowledge that there is a cease fire. 4. Members and Guests while shooting at the range, either on a practice day or tournament, will walk from target to target using the prescribed marked trails, in an ascending order. (Example: Target #7 to Target #8) No shortcuts or back-tracking allowed. 5. When looking for lost arrows, YOU MUST “PROTECT” THE TARGET. If you are alone take the paper target off the face of the butt and place your bow in front of the butt to let the next person know you are behind the butt. If you are in a group, one person must always stay visible, in front of the butt, knock-a-block or 3D target, “protecting” the target. If alone and looking for lost arrows at a knock-a-block or 3D target, place your bow conspicuously in front of the target to let the next person know you are there. 6. Members and Guests will only shoot at prescribed target butts, 3-D targets, knock-a-blocks, etc. (no aiming at trees or animals). 7. Never shoot up into the air, Suffolk's Range is not a flight range. Point arrows only at targets during the drawing process. If your bow draw-weight is so high that you must point your arrow skyward to pull the string, reduce poundage. 8. Never put an arrow on the bow string until it is safe to shoot. 9. It is the responsibility of every archer to insist upon strict standards of safety and courtesy. 10. A person acting unruly or in an unsafe manner will be asked to leave. 11. No alcoholic beverages or illegal drug use allowed on club grounds. 12. The entrance gate shall be closed and locked upon entering and upon leaving to discourage trespassing, and the combination of the lock shall be moved so that trespassers cannot learn the combination. Local emergency response teams have been provided with the lock combination, so they can enter in an emergency. Make Suffolk Archers a SAFE place to shoot. Archery Safety is a matter of common sense, every precaution must be taken to insure the highest possible safety standards. .
I have read the enclosed Suffolk Archers’ SAFETY RULES and POLICIES, I understand them, and agree to abide by them at all times. Yes
2010 Member Participation for Dues Reduction Section
If you have elected to assist with club duties, please choose two or more events (below) that you wish to help with, and the chairman of these events will contact you to confirm your scheduled commitment and discuss your responsibilities. If you are assisting with club duties, you are responsible for completing the 8+ or 16+ hours of actual participation, to earn credit toward your dues. Participation opportunities may be limited, so please be proactive in arranging your assignments, and fulfilling your commitment.
Event	Check Days Available to Assist
Long Island Traditional	Set up: 6/5/2010 Event & Take Down: 6/6
Knock a Block	Set up: 7/10/2010 Event & Take Down: 7/11
Hunter Shoot 3D	Set up: 8/21/2010 Event & Take Down: 8/22
Bow Hunter Rendezvous	Event & Take Down: 9/11/2010
Silver Arrow Shoot 3D	Set up: 9/11/2010 Event & Take Down: 9/12
Range Work Days Be sure to check the web site for cancellations due to bad weather	Day 1: 3/21/2010 Day 2: 3/28/2010 Day 3: 8/29/2010 Day 4: 12/5/2010
Range Committee Arrange with Range Captains	Yes
Field Committee Arrange with Range Captains	Yes
Special Permissions Section
SUFFOLK ARCHERS WILL NEVER SHARE YOUR PERSONAL INFORMATION WITH ANY OTHER ORGANIZATION, BUSINESS OR PERSON WITHOUT YOUR PERMISSION, UNLESS COMPELLED TO DO SO BY A COURT OF LAW. Please initial the two boxes below if you wish to grant this permission
By joining Suffolk Archers I specifically grant permission for Suffolk Archers to capture, take, or acquire photographs or other images of my person and my participating family members for ONLY the purpose of promoting or advertising Suffolk Archers. I and my family members will receive no monetary compensation for the above. I Agree
I grant Suffolk Archers permission to share my email address with archery related companies or organizations who may from time to time send me archery related information such as special events, opportunities, product information. I Agree
Liability Waiver/Release Section
In consideration of being allowed to participate in any way in Suffolk Archers, Inc. events and activities, the undersigned acknowledges, appreciates, and agrees that: I ) The risk of injury from archery and other known and unknown events and activities and/or the use of the related buildings, structures, equipment, automobiles, firearms, weapons, ATVs, boats, tree stands, roads, bodies of water, land and all other real and personal property whether owned by archery club or others is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist, and 2) I acknowledge and agree that the use of archery equipment or any other items by myself or others on club premises or otherwise are inherently dangerous and high risk activities whether such archery equipment are discharged or used in any way by myself others, and 3) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown. EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation, and, 4) I willingly agree to comply with the stated and customary terms and conditions for participation If however, I observe any unusual significant hazard during, my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately, and, 5) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin. HEREBY RELEASE AND HOLD HARMLESS Suffolk Archers Inc., its officers, directors, officials, agents, employees, volunteers, members, guests, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of real property and personal property used to conduct the events and activities (“RELEASEES"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, TO THE FULLEST EXTENT PERMITTED BY LAW. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. I Agree
Release for Participatants of Minority Age Section (Under 18 at time of participation)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's involvement or participation in these events and activities and/or the use of related real and personal property as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE. I Agree
First Minor's Name
Second Minor's Name
Parent or Guardian's First and Last Name
Emergency Phone Number
Completed Waiver/Release forms should be kept on file by the club for at least 7 years and indefinitely in the event of a significant injury to a particular participant. COMPLETE A SEPARATE FORM FOR EACH FAMILY MEMBER. Make additional copies of this form if necessary.
See Club Policies Here.