MEMBERSHIP APPLICATION
There are several ways to join our club.
1. Attend any meeting or event at the club and sign up here.
2. Memberships are available at Mike’s Baits and Tackle in Nazareth, Friendly Mart gas station in Stockertown, and Chubby's in Forks Township.
3. Join by mail – Print & send the form to Stockertown Rod & Gun Club, PO BOX 485, Stockertown, PA 18083-0485.

1 year - Adult Membership - 16 years to 65 years - 2025    $50.00
3 year - Adult membership - 2025, 2026, 2027                         $125.00
1 year - Senior Citizen Membership - Age 65+ - 2025          $25.00
1 year - Junior Membership - Ages 10 through 15 - 2025    $25.00
               (Under age 10, membership is optional for fishing but required on the ranges.)

A MEMBERSHIP BUTTON MUST BE WORN AND MEMBERSHIP CARD CARRIED WHILE USING CLUB FACILITIES!
READ and OBEY ALL CLUB RULES!!
MEMBERS ONLY ON ALL RANGES – NO GUESTS or OBSERVERS ALLOWED.

FOR EACH MEMBERSHIP REQUEST - PLEASE PRINT or TYPE
Membership Type please check one [ ] 1 year [ ] 3 yr. [ ] Sr. (age 65+) [ ] Jr. (under 16)

Name __________________________________________________ Age ____________

Mailing Address _________________________________________________________

City ____________________________________ State __________ Zip _____________

Phone ___________________________________________________________________

Email Address (optional) __________________________________________________

Make check payable to Stockertown Rod & Gun Club and mail to PO Box 485, Stockertown, PA 18083