ECCL New Membership Application

Please complete all areas for processing. Only one person per application. (choose from ONE of the options below for each person.) If you would like to add an associate or junior, they must fill out a separate application. Applicants accepted for membership must attend a safety orientation to complete processing and become a member. Your safety orientation will generally be held the Saturday after the monthly general meeting. General Meetings are held the 1st Thursday of each month at 7 pm. New members will receive an email of acceptance including an invitation to attend the next general members meeting and details about the safety orientation. A valid Driver's License must be presented upon registration for the Safety Orientation session.

Each section of this application must be completed in full:

  • A check for fees must be mailed to ECCL, 815 Mason Rd E, Milan Rd OH 44846 by the deadline if you do not use the credit card option for payment.
  • All applications must have a current club member sponsor. Sponsors must be in good standing with no less than 1-year active senior, associate or life membership.

Membership Level Options

 

TOTAL PAYMENT

Total: $

Questions? You may email ecclclubhouse@gmail.com.

Experience History:

Please fill in the blanks with number of years or experience.

ON REVIEW OF THIS APPLICATION, IF YOU HAVE NO FIREARM EXPERIENCE OR ARE A BEGINNER, YOU WILL BE REQUIRED TO COMPLETE A FIREARM SAFETY COURSE WITH A QUALIFIED INSTRUCTOR AND PRESENT PROOF OF COMPLETION OF A QUALIFIED FIREARM SAFETY COURSE WITH THIS APPLICATION.

DECLARATION AND LIABILITY HISTORY DECLARATION REGUARDING MATERIAL ASSISTANCE / NONASSISTANCE TO A TERROIST ORGANIZATION

Any answer of “yes” to any question, or the failure to answer “no” to any question on this declaration shall serve as a disclosure that material assistance to an organization identified on the U.S. Department of State Terrorist Exclusion List has been provided. Failure to disclose the provision of material assistance to such an organization or knowingly making false statements regarding material assistance to such an organization is a felony of the fifth degree. For the purposes of this declaration, “material support or resources” means currency, payment instruments, other financial securities, funds, transfer of funds, and financial services that are in excess of one hundred dollars, as well as communications, lodging, training, safe houses, false documentation or identification, communications equipment, facilities, weapons, lethal substances, explosives, personnel, transportation, and other physical assets, except medicine or religious materials. In accordance with section 2909.32 (A)(2)(b) of the Ohio Revised Code for each question, write your initials on the line “yes” or “no”.

***Responses must be truthful.

DECLARATION OF CRIMINAL HISTORY

I affirm that I have not been convicted of, plead guilty to, had a judicial finding of guilt for, or had a judicial finding of eligibility for treatment and/or intervention in lieu of conviction for, any other felony or misdemeanor that would cause me to be under a disability to own or have control of a firearm. I attest that all information provided is true and accurate. Any false statement will be grounds for denial, suspension, revocation or other disciplinary action taken by the Erie County Conservation League.

RELEASE OF LIABILITY

In consideration of my application and permitting me to participate in all activities on the Erie County Conservation League Inc. I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to, THE FOLLOWING ENTITIES OR PERSONS: (ECCL) officers, employees, volunteers, representatives, and agents, the activity or event holders, activity or event volunteers; (B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity or event, whether caused by the negligence of release or otherwise. I acknowledge that the (ECCL) and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific event or activity on behalf of the (ECCL) I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity or event. I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers, and assigns. The accident waiver and release of liability shall be construed broadly to provide a release and waiver to the Maximum extent permissible under applicable law.

I CERTIFY THAT I HAVE READ THIS DECLARATION/LIABILITY OF THIS APPLICATION AND I UNDERSTAND IT’S CONTENT AND MY ANSWERS ARE TO BE TRUE. I SIGN IT AT MY OWN FREE WILL.

OPTION FOR JUNIOR MEMBERS

Signature PARENT / GUARDIAN WAIVER FOR JUNIOR APPLICANTS: The undersigned parent and natural guardian does hereby represent that he/she is, in fact, acting in such capacity, has consented to his/her child or ward’s participation in membership of the ECCL, and has agreed individually and on behalf of the child or ward, to the terms of the Declarations and release of liability set forth above. The undersigned parent or guardian further agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim, or damage whatsoever which may be imposed upon said parties, because of any defect in or lack of such capacity to so act and release said parties on behalf of the minor and the Parents or legal guardian.

NOTE: A photo ID or Valid Driver’s License will be required on the day of your New Member Orientation.