Membership | Mad River Club

Applicant Name*

First Middle Last Suffix

Spouse's Name

First Middle Last Suffix

Date of Birth*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email

Occupation*

Hobbies & Interests

Sponsor's Name*

First Last

Sponsor's Badge Number*

Sponsors Relationship to Applicant*

The following is a listing of committees, workday events and skills that require membership participation. Which activities are you willing to participate in or have experience in.*

Select all that apply (for Multiple selections hold the control key and click on multiple lines)

Are you willing to support MRC fund raisers*

Yes
No

Are you a Veteran or currently in the military?*

Veteran
Currently in military
No Military

Have you been or are you currently: (select all that apply)

associated with or a participant and/or member of any anti-hunting organization
associated with or a participant and/or member of any anti gun organization
convicted of a offense involving the use of a rifle or hand gun of any type
convicted of a offense involving hunting, fishing, trapping or similar activity

Note: An answer of Yes to the any of the above questions does not mean the applicant would/will be dropped from consideration. He/She will be given the opportunity to explain the circumstances to a Yes answer. This will be considered by the Board as well the membership for final approval.

Has your spouse or significant other been or is currently: (select all that apply)

associated with or a participant and/or member of any anti-hunting organization
associated with or a participant and/or member of any anti gun organization
convicted of a offense involving the use of a rifle or hand gun of any type
convicted of a offense involving hunting, fishing, trapping or similar activity

Note: An answer of Yes to the any of the above questions does not mean the applicant would/will be dropped from consideration. He/She will be given the opportunity to explain the circumstances to a Yes answer. This will be considered by the Board as well the membership for final approval.

Consent*

By selecting this box I am agree that all the above information is correct and true.

Falsification or failure to answer any information requested in this application by the applicant may result in his/her immediate termination.

Consent to Sponsor*

I confirm that the above member as agreed to sponsor me, if this is found untrue I understand that my application will not be accepted

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If you would like to join the Mad River Club, you can fill out an application by filling out the form below. After filling out the application you will need to mail in a $50 non-refundable application fee (checks made out to the Mad River Club).

The application fee can also be paid via Square. Once the application and the application fee is received you will be placed on the waiting list. Mail checks to Mad River Club P.O Box 171 Pulaski, New York 13142-0171 or use the underlined Square platform above to pay online.

If you’d like, print this page and mail in the application (this does take a little longer to process). Click the underlined application in the previous sentence to find an easy form to print (2-pages).

The current waitlist is 5+ years long, please let the people you are sponsoring know.

Membership Application

Building & Grounds Maintenance
Carpentry
Equipment Operator
Hunter Safety programs
Rifle Range
Legislative Issues
Children’s Ice Fishing Derby
Roads & Trails Posting
Electrical
Computer Skills
Trapping Instructor
Book Keeping / Financial
Federation Meetings
County Fair Booth
Welding /Fabrication
Plumbing /Heating
Fundraising
Waterfowl ID
Legal
Children's Trout Derby
Kitchen Duty
3D Archery Shoot