B BAR L Family Membership Application
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Last Name
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First Name
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Birthdate
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Home Street Address
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Mailing Address
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City, State, Zip Code
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Home Phone #
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Cell Phone #
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E-mail Address
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Employer
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Employer Phone #
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Employer Address (Street, City, State, Zip)
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Supervisor's Name
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Your Job Title/Position
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Hunting Character Reference #1
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Phone #
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Hunting Character Reference #2
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Phone #
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Height
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Weight
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Eye Color / Hair Color
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Driver's License #
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State of Issue
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Date of Expiration
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Are you a citizen of the USA?
Yes
No
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Have you previously applied for membership in B BAR L or any club affiliated with B BAR L?
Yes
No
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Are you a member of any group opposed to the US Government?
Yes
No
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Do you agree to never accept payment as a guide on B BAR L land?
Yes
No
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Have you ever been convicted of a felony?
Yes
No
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Have you ever been convicted/fined for wildlife violations?
Yes
No
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Are you on probation for any criminal offense?
Yes
No
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Have you ever injured anyone while hunting?
Yes
No
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Have you every sued anyone from person injury from any cause?
Yes
No
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Have you ever claimed compensation from anyone for property damage or injury resulting from a hunting accident?
Yes
No
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Have you been treated for addiction to a controlled substance or alcohol within the past year?
Yes
No
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Do you have any physical or mental disabilities which could place you or others at risk of injury when you and others are hunting?
Yes
No
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Have you completed a Hunter Safety Course?
Yes
No
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If yes, list state, year and certificate #
Download photo of yourself for Photo ID Card
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You are applying for a Family Membership, is this correct?
Yes
No
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By checking this box you are electronically signing this application.
Signature
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Indicates Response Required
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