N AT I ON A L S H OO TI N G ASSOCIATION Accredited with SAPS (CFR) as Hunting Association: FAR 1300050 Sport-shooting Association: FAR 1300088 34 Minni Street, Clydesdale, Pretoria, 0002. PO Box 190, Menlyn, Pretoria, 0063. Tel: 012-‐343-‐3236 | 012-‐343-‐1078 Fax: 0865 113 555 Email: admin@natshoot.co.za Web: www.natshoot.co.za Responsible and Accountable F irearms Ownership LIST YOUR SHOOTING RANGE AS A NSA FRIENDLY RANGE Name of range:____________________________________________________________________________________ Name of owner:___________________________________________________________________________________ SAPS (CFR) accreditation number: (if registered – not necessary)___________________________________________ Please indicate by marking the relevant: Indoor range Yes No Outdoor rang Yes No Distance of longest range: ___________________________________________________________________________ Physical address of range:___________________________________________________________________________ Postal address:____________________________________________________________________________________ Telephone: Code_____________ number:____________________________ Fax number: Code_____________ number_____________________________ Cell:__________________________________ E-mail address:_____________________________________________ Name, surname and telephone number of person the NSA will be able to contact in emergencies, and will be sure to make contact with:______________________________________________________________________________________ By submitting this form it is mutually understood that details of your valued institution will be placed on the NSA website, and that NSA members will be able to make use of your range at the costs which you determine. It is also understood that the shooting range official will sign the targets of NSA members and affix a range stamp on said targets with date of shoot. The shooting range is not responsible to send any targets to the NSA, and is not responsible to issue NSA members with targets or step-by-step guides – that remains the responsibility of the NSA member who uses the shooting range. All and any form of indemnity for activities at the shooting range remains the responsibility of the shooting range. NSA will in no way become involved in any of these matters should any form of indemnity claims occur due to a NSA member using the shooting range or its related facilities. _______________________________ Signature of responsible person _____________________________ Name in print __________________ Date