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                   The Manistee Clan Muzzle Loading Club
                                        3125 Camp Road 
                          (location only - not mailing address)
                                 Manistee, Michigan 49660

                       Membership Application & Renewal
                                   Please fill out and return to:
                           Manistee Clan Muzzle Loading Club
                           Henry Rozmarek, Membership Chairman
                           P.O. Box 76
                           Manistee, MI 49660-0076

Name____________________________________________________________________

Address__________________________________________________________________

City__________________________________State________________Zip+4___________

Phone # (______)________-_______________Member No. Assigned_________________

Do you want your newsletter by email?  Email____________________________________
National Rifle Assoc. number: ______________________Expires: _____/_____/________
I affirm that I am not a felon and have no felonies against me.
Signature: _____________________________________________

Manistee Clan Muzzle Loading Club annual dues (Jan.-Dec.)..............$40.00
I hereby attest to the character of the above named candidate and recommend 
him or her for membership in the Manistee Clan Muzzle Loading Club.

Signed_____________________________________________Member No.____________

                                                           Obligation
  In the presence of Almighty God, I do of my own free will and accord solemnly promise and 
declare that I will comply with the bylaws and ritual of this club and will always be loyal thereto - 
that I will never wrong or defraud this organization nor a member thereof nor permit any wrong to 
be done to either if in my power to prevent it.
  I will never propose for membership any person not eligible nor one who I know to be unworthy.
  I will never make known to anyone not authorized to receive it the work of this club. Should my 
affiliation with the Manistee Clan Muzzle Loading Club cease in any way, I will consider this pledge 
as binding outside of this club as though I had remained a member of the same. 
  I have read and agree to abide by the club range safety rules.
All this I promise and pledge upon my honor and as a citizen of this great republic.

Applicant's Signature_________________________________________Date:_____________