Port Coquitlam & District Hunting & Fishing Club

Home to thousands of target shooters, archers, law enforcement, hunters and outdoor enthusiasts since 1956.

Membership Registration / Renewal

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Membership Registration / Renewal

Your Information
Membership Type:*
- New Member
- Renewing Member
Membership Card Number:*
Name:*
First Middle Initial Last
Address:*
Street Address Address Line 2 City Province Postal Code
Phone:*
Email:*
Enter Email Confirm Email
Photo Upload
Must be in jpg format and less than 2MB.
Accepted file types: jpg, jpeg, Max. file size: 2 MB.
Emergency Contact Information
Emergency Contact Name:*
First Last
Emergency Contact Phone:*
Additional Information
All firing ranges are mandated by law to collect licensee information. This information is otherwise kept confidential.
Date of Birth*
Month
Day
Year
Do you have a PAL?*
- Yes
- No
PAL Classification:*
Check all that apply.
- Non-Restricted
- Restricted
- Prohibited
PAL Number*
0 of 13 max characters
Expiration Date:*
MM slash DD slash YYYY
What are your main Club Interests?*
- Archery
- Black Powder
- IPSC
- PPC
- Small Bore
- Hunting
- Fishing
- Target Shooting
- LEAP
- Trap & Skeet
- Other
If other, please specify:
Agreement
Club Policies*
Any person shooting on club property must be able to understand English range commands or provide their own translator who must be at the bench with him/her at all times. I agree to the Language policy.*
Contact Policy*
I consent to PCDHFC contacting me by email for official club correspondence only.*
Membership Policy*
I certify that I am eligible to apply for a Membership.*
Membership
Individual Membership - $256.00: Any individual 18 years or older.

Family Membership - $330.00: Includes a spouse and any children under the age of 18.

Senior Membership - $110.00: Any individual 65 years or older

Junior Membership - $88.00: Any individual under the age of 18 with written permission of a parent or guardian.
Yearly Membership Fee:*
Junior Policy*
I certify that I am under the age of 18 and qualify for a Junior Membership.*
Name of Spouse:*
First Last
Names of Children under the age of 18:
Use plus icon on the right to add more rows.
First Name Last Name Age
One-time New Member Course:
Price:
One-time New Member Course:
Price:
One-time New Member Course:
Price:
One-time New Member Course:
Price:
Total:
$ 0.00 CAD
Payment Information
Credit Card*
*You must click on the text for each field to enter credit card number, expiry and CVC
Card Details
Cardholder Name
By submitting this form you agree that you need to come in to the office to arrange for your photo ID membership card that serves as your official proof of membership.

Please review your information carefully before hitting submit.

First Name	Last Name	Age

Membership Registration / Renewal

Your Information

Emergency Contact Information

Additional Information

Agreement

Membership

Payment Information