Membership Renewal  Form

Online application

Please fill in this form by November 30, 2021.  A copy will be sent to your email, please check your spam/junk mail.

Payment may be cheque or money order mailed with this form or e-transfer to

  • ** Members are responsible for ensuring their CSSA membership is valid when attending HCMC**
  • Expiry date is just month and year, so put in any date for day.
  • QualificationDate Qualified (mm/dd/yyyy)Club or Certifying Association: 
  • Drop files here or
    Accepted file types: jpg, jpeg, png, pdf, Max. file size: 3 MB, Max. files: 3.
    • *Family Membership: Member + Spouse + Children seventeen years of age or younger and children living at home and in attendance at school under the age of 21. Family members who are regular, active shooters should fill out separate renewal forms and attach them to the main membership renewal.
      †Junior Membership: Member who has not reached his/her 18th birthday.
    • By ticking this box, I acknowledge that I have read, and agree to abide by, Haliburton County Marksmen Club Inc. by-laws, rules, range safety basics and related guidelines as displayed on the website, posted at the Club, or otherwise made available. I understand that non-compliance may result in Club discipline that may include suspension of membership and/or range access.

    PDF Application with Fillable form

    This form can be filled out and digitally signed using Adobe Acrobat Reader.

    Please fill in this document, print it, sign it, and mail it to:
    Haliburton County Marksmen Club Inc., P.O. Box 56, Kinmount, ON K0M 2A0 by November 30, 2021.
    Payment may be cheque or money order mailed with this form or e-transfer to