Yes! I would live to be a part of the CLHA!

Name: _______________________________ Age: ___________

Address: _____________________________________________

City: _______________________ State: ______ Zip: _________

Telephone Number: (Home) _____________________________

Telephone Number (Work) ______________________________

E-mail Address: ________________________________________

Do you own a flintlock firearm? YES_____NO____

If you are a New Jersey resident,
do you have a NJ Firearms ID Card?
YES_____NO____

Please List all family members who would be participating:
Name Age
______________________________ _________
______________________________ _________
______________________________ _________
______________________________ _________
______________________________ _________
______________________________ _________
______________________________ _________

Date: _________ Signature: ______________________________

When completed, please mail to: Bill Cooper CLHA PO Box 531 Blairstown, NJ 07825