Corporate Membership Application

Company*

Company Address*

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

Member 1 Name*

First Last

Member 1 Title

Member 1 Email*

Member 1 Phone*

Member 1 Date of Birth*

Member 1 Address*

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

Member 1 Emergency Contact*

Member 1 Emergency Contact Phone*

Member 2 Name*

First Last

Member 2 Phone

Member 2 Date of Birth*

Member 2 Address*

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

Member 2 Title

Member 2 Email*

Member 2 Emergency Contact*

Member 2 Emergency Contact Phone*

Member 3 Name*

First Last

Member 3 Phone*

Member 3 Date of Birth*

Member 3 Address*

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

Member 3 Title*

Member 3 Email*

Member 3 Emergency Contact*

Member 3 Emergency Phone*

Member 4 Name*

First Last

Member 4 Phone*

Member 4 Date of Birth*

Member 4 Address*

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

Member 4 Title*

Member 4 Email*

Member 4 Emergency Contact*

Member 4 Phone*

How did you hear about Network Outdoors?

Please check all areas of interest that apply:*

Other

Are you interested in sponsoring events?*

Yes

Are you interested in participating in land/water/wildlife conservation efforts?*

Yes

Are you interested in participating in new hunter/angler promotion programs?*

Yes

AGREEMENT TO PARTICIPATE AND AUTHORITY FOR PRE-AUTHORIZED MEMBER PAYMENT**

I agree

Participation

I agree to attend a minimum of four (4) of the established events each calendar year. I fully comply with the policies and procedures of Network Outdoors. I give my consent to use photographs I may appear in to promote Network Outdoors through print, email, and internet social media channels.

Membership Fees and Dues

Company member agrees to a nonrefundable annual membership fee of $2,500. A portion of this will be used to pay for the Member Only Annual Trip Event.

Total monthly company member dues are $200 per month. This amount covers up to 8 registered individuals within the company. Dues will be collected electronically on a monthly basis.

I authorize Network Outdoors to charge the credit card indicated in the authorization form below. I understand that this authorization will remain in effect until I cancel it in writing and I agree to notify the business in writing of any changes in my account information or termination of this authorization at least 30 days prior to the next billing date. I certify that I am an authorized user of this credit card and that I will not dispute the scheduled payments with my credit card company provided the transactions correspond to the terms indicated in this authorization form.

Email: members@networkoutdoors.com

Annual Membership Fee*

Price:

Monthly Dues*

Price:

Credit Card*

Card Details

Cardholder Name

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