print out and send to:
 
NewMexicoWildBunch.com
P. O. Box 11
San Patricio, NM 88348
(505) 653-4285
 
 

New Mexico Wild Bunch
Membership Application
 
 

Applicant Name:____________________________________________________________________________ 

Alias:_____________________________________________________________________________________ 

Address: __________________________________________________________________________________ 

City, State & Zip:___________________________________________________________________________ 
_________________________________________________________________________________________ 

Phone: _____________________________________Cell:__________________________________________ 

I agree that I will not hold the Sponsor, Host, City, County, State, Fast Draw club or any officials, employees, or servants of such, responsible for any injuries as a result of my participation in any part of this or any club activity. I furthermore agree to follow all safety rules and conduct. I shall dry fire only in an approved area. 

Membership dues for the New Mexico Wild Bunch are $35.00 individual or $55 for a family.

I have read and understand the agreement and agree to abide to the same: 

Signature: ___________________________________ Amount Paid:___________________________ 

Date: _______________________________________ Date:__________________________________ 
 

Received By:____________________________ (NMWB Office)


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