Sackville Rod & Gun Club Guest Shooter Form

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The Sackville Rod and Gun Club is the operator of the Walker Road Range (485 Walker Road, Sackville, NB). The range is private so shooters must either be members or authorized by the club to shoot (IE. – authorized guests, etc). This form is for those wishing to visit our range as an authorized guest.

Guest shooters also need to pick up a sighting-in permit from DNRED in Dieppe and follow any responsibilities therein.

It is the responsibility of the guest shooter to submit the form and pay the appropriate fees. Without doing so, the individual is not authorized and is trespassing. Range safety officers check periodically on usage and will report any unauthorized use.

First Name
*

Middle Initial
*

Last Name
*

Preferred/Nickname

Date of Birth
*

YYYY

Address *

City/Town
*

Province
*

Postal Code
*

Phone number *

Email *

PAL Number
*

I certify that 1) the above information is correct 2) I am not prohibited from owning or using firearms 3) I will obey all posted rules during my use of the range facilities. (Type full name to certify) *

Are you accompanying an active member as a guest?
*

Yes

Active Member Name

Date of Visit
*

YYYY

Visit Type with Fees Explained
*

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