APPLICATION FOR MSA AFFILIATE CLUB MEMBERSHIP

FOR AN EXCLUSIVE TERRITORY/REGION

I, the undersigned, hereby apply for application of our Affiliate Club Membership for the area known as ____________________________, as my exclusive Territory/Region.

The term for this affiliate membership, if accepted, will be one (1) year, unless sooner terminated by MSA for any reason at the sole discretion of MSA at any time.

This agreement is renewable annually based upon the affiliate membership contract terms in force at the time of renewal.

Your MSA Affiliate Membership will include the following features:

1. Exclusive Territory/Region*
2. Software for match and record keeping.
3. Affiliate insurance coverage for up to 6 MSA sanctioned matches per year. All competitors MUST be current MSA members. Should your venue require additional riders, your club will be charged an additional $25 match fee. 
4. MSA certified and approved ammunition to be used exclusively to maintain the highest quality, standards and uniformity.
5. You will be provided some “Basic Guidelines” for your shoots.
6. Mandatory use of the 16 MSA sanctioned shooting stages (downloadable from the MSA website at no cost to you)
7. MSA Rulebook is downloadable from the MSA website at no cost to you.
8. Your affiliate club is responsible for sending the MSA office all results of any sanctioned shoot held so they can be posted on the MSA Website, along with a $10.00 fee for each shooter in either the main match, rifle, shotgun and/or the 20X within 78 hours of the match.

Your total cost for all of this is just $400.00 per year and that includes all updates and/or changes to the affiliate program free.

 Just complete the information below and return the completed and signed original along with your affiliate fee of $400.00.   MSA will see that you receive everything described above promptly. Plus if you apply now, you will receive email, and if urgent, telephonic access to MSA to handle any questions you may have about implementing and running the MSA system as your mounted shooting program. Once you have the system you’re ready to hold matches. Your club keeps its share of the entry fees. You send MSA your results, and an amount equal to $10.00 per entry at each match within 78 hours of the match.

  Please fill out the requested information below on this form and return the original, plus your $400.00 affiliate fee to MSA. 

Name of Contact Person:_________________________________ 

Name of MSA Affiliate Club:_______________________________ 

Address of Club:__________________________________________ 

                          ___________________________________________ 

Phone Number:__________________________________________ 

FAX Number:______________________________________________ 

E-mail Address:__________________________________________ 

Website address (if any):_____________________________________ 

Signature:____________________________________ 

Date:________________________________________

* Any territory/region is subject to modification at any time in the sole discretion of MSA

For more information on the Mounted Shooters of America please visit: www.NEWMSA.com