Full Name :: Please enter your first, last and middle name if you have one.
 
 
 
 
 
Date Of Birth :: mm/dd/yyyy
 
 


 
 


 
If you are or may be pregnant or nursing we strongly recommend you refrain from shooting.
 
 
 
 
 


 


 


 


 


 


 


 
 
 
 
 
*Note there will be a 15% fee for rescheduling once you are confirmed for this class.
 


 
 
If you are applying for Advanced or Security training, please complete the below questions. If you are NOT, skip to the bottom to complete the Anti-Spam verification and press 'submit'.
 


 


 
 
Weight (Lbs.) :: Please enter your weight in pounds US, i.e. 165
 
Eye color :: Please enter: BLU (Blue) BRO (Brown) GRY (Gray) GRN (Green) HAZ (Hazel)
 
Hair color :: Please enter: BAL (Bald) BLK (Black) BLN (Blonde/Strawberry) BRO (Brown) GRY (Gray/Partially Bald) RED (Red/Auburn) WHI (White)
 


 
Highest level of education? :: Please indicate HS / GED, 2 year degree (Associate), 4 year degree (Bachelor), Graduate Degree (Masters) Post-Grad (Ph.D, J.D., M.D., etc.)
 
What (valid) certifications do you currently hold? :: Please indicate, CPR, NRA, EMT, etc. If none, please enter 'none' or 'n/a'.
 


 
In case of emergency, who should we contact? :: Please indicate contact name, phone number(s) and relationship (husband/wife, brother/sister, etc.)
 
 
Please list any allergies, including dog, if any: :: If no known allergies, enter 'none' or 'n/a'
 


 
Any medical condition of concern? :: Please indicate if you have any known or suspected medical condition that would present a risk to you or the instructors. If none known, enter 'none' or 'n/a'.