BCRS Landowner/Acreage Registration Form
NCBA-BCRS liability insurance covers active “BCRS Members” on all lands they bowhunt on that are “Registered” with the NCBA-BCRS office. Please use the form below to list all properties you bowhunt upon that you want the insurance to cover you on when you are bowhunting. This information is “confidential” and will NOT be disseminated to anyone other than the BCRS Chairman; and to the NCBA Executive Council and insurance company in the event a claim is filed.
This form may be sent to the BCRS Chairman along with your “BCRS Membership Application” , or at any subsequent time afterward for revision and/or updating. Use additional sheets if necessary. (*Please PRINT or TYPE legibly.)
BCRS Member Number: M-_____________ Date: _________________________
BCRS Member’s Name: _________________________________________________
Location (County): Landowner’s Name: Acreage (Approx.)
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Return to: NCBA-BCRS; 7796 NC 68; Stokesdale, NC 27357