2808 NW Hunter Drive, Blue Springs, MO 64015 | Fax (816) 224-9595 | Email: huntingsportsplus@comcast.net | Tel (816) 220-1000
Name Home street address
City/St/Zip County Since Status Home Phone
Phone Under Cell Phone Email
Mailing Address (if different)
Employer Address
City/St/Zip Phone Type of Bus. Started
Position Dept. Supervisor
List two hunting/character references below who will testify you are a safe & ethical hunter. (Must be unrelated and known for over 5 years)
1. Name Phone 2. Name Phone
Please answer the following 20 questions yes or no with a \"Y\" or a \"N\".
1. Are you a member of the NRA? | 13. Has any other hunting club refused to renew your membership? |
Identification: Drivers License Number State Issued By Expires Weight Height
Hair Color Eye Color Skin Color Birthdate Marital Status
Have you ever completed a hunter's safety training course? State Year
List all vehicles to be used while using club property:
Make Model Color Year 4x4? Plate Number State
Make Model Color Year 4x4? Plate Number State
If you are currently a member of another hunting club please tell us which one Year Joined
If you are a former member of another hunting club please tell us which one Year Terminated
Describe any hunting dogs you will be using (breed, color, etc.)
List all dependents (spouse & dependent children) who may accompany you as your guest: Qualified dependents must be listed as dependents on your
income tax return.A signed HSP indemnification agreement must be received for each dependent prior to their access to club land, including infants.
Name | Sex | Birthdate | Relation | Name | Sex | Birthdate | Relation | ||
1. | 4. | ||||||||
2. | 5. | ||||||||
3. | 6. |
Estimated number of days each year I may use club land to hunt for: quail , pheasant , duck , goose , dove , turkey/bow , turkey/gun
deer/bow , deer/gun , grouse , prairie chicken , squirrel , rabbit , coyote , raccoon , prairie dog , elk , antelope , boar , camp , fish
I want to hunt in:
Show your four most favorite states in order of importance
How did you hear about us? (Name sponsor if any)
Approval is given to charge $ to credit card number Expires / (add MO sales tax)
CREDIT: Circle number if you have: 1. Checking account, 2. Master Card, 3. Visa, 4. Discover, 5. American Express
Misleading or false information given to obtain membership will result in revocation of membership and forfeiture of money paid upon verification of intent to deceive HSP or any affiliate clubs. Print and read this agreement (click here), and if fully understood sign before submitting application for approval.
APPLICANT SIGN HERE (X) Date //
Approved by Total Due $ Paid $ Balance Due $ To be paid as follows
2808 NW Hunter Drive, Blue Springs, MO 64015 | Fax (816) 224-9595 | Email: huntingsportsplus@comcast.net | Tel (816) 220-1000
Name Home street address
City/St/Zip County Since Status Home Phone
Phone Under Cell Phone Email
Mailing Address (if different)
Employer Address
City/St/Zip Phone Type of Bus. Started
Position Dept. Supervisor
List two hunting/character references below who will testify you are a safe & ethical hunter. (Must be unrelated and known for over 5 years)
1. Name Phone 2. Name Phone
Please answer the following 20 questions yes or no with a \"Y\" or a \"N\".
1. Are you a member of the NRA? | 13. Has any other hunting club refused to renew your membership? |
Identification: Drivers License Number State Issued By Expires Weight Height
Hair Color Eye Color Skin Color Birthdate Marital Status
Have you ever completed a hunter's safety training course? State Year
List all vehicles to be used while using club property:
Make Model Color Year 4x4? Plate Number State
Make Model Color Year 4x4? Plate Number State
If you are currently a member of another hunting club please tell us which one Year Joined
If you are a former member of another hunting club please tell us which one Year Terminated
Describe any hunting dogs you will be using (breed, color, etc.)
List all dependents (spouse & dependent children) who may accompany you as your guest: Qualified dependents must be listed as dependents on your
income tax return.A signed HSP indemnification agreement must be received for each dependent prior to their access to club land, including infants.
Name | Sex | Birthdate | Relation | Name | Sex | Birthdate | Relation | ||
1. | 4. | ||||||||
2. | 5. | ||||||||
3. | 6. |
Estimated number of days each year I may use club land to hunt for: quail , pheasant , duck , goose , dove , turkey/bow , turkey/gun
deer/bow , deer/gun , grouse , prairie chicken , squirrel , rabbit , coyote , raccoon , prairie dog , elk , antelope , boar , camp , fish
I want to hunt in:
Show your four most favorite states in order of importance
How did you hear about us? (Name sponsor if any)
Approval is given to charge $ to credit card number Expires / (add MO sales tax)
CREDIT: Circle number if you have: 1. Checking account, 2. Master Card, 3. Visa, 4. Discover, 5. American Express
Misleading or false information given to obtain membership will result in revocation of membership and forfeiture of money paid upon verification of intent to deceive HSP or any affiliate clubs. Print and read this agreement (click here), and if fully understood sign before submitting application for approval.
APPLICANT SIGN HERE (X) Date //
Approved by Total Due $ Paid $ Balance Due $ To be paid as follows