NRA COURSE APPLICATION
PRE-REGISTRATION IS REQUIRED. CALL
THE CLUBHOUSE AT 352-597-9931 TO REGISTER.
OUR RECEIPT OF YOUR APPLICATION AND FEE WILL BE YOUR CONFIRMATION IN THE
CLASS.
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Please
complete application and remit with your check or money order. Payable
to the Hernando Sportsman’s Club. Mail to
Deposit is NOT refundable unless course is canceled
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Name: Hm Ph:
Address: Wk Ph:
City: Date of Birth:
State: Zip:
Reason for Attending
Class:
Please check NRA Course
you are registering for and if you are currently an NRA instructor, please
provide a copy of your certification:
STUDENT: INSTRUCTOR:
Pistol _____
$100 Pistol _____ $150
Rifle _____
$125 Rifle _____ $145
Shotgun _____
$100 Shotgun _____ $150
Range Safety Officer _____
$150
I the
undersigned hereby waive any claim or cause of action of any nature whatsoever
arising as a result, or in connection with, the instructors or the use of the
facilities, or arising from my presence on or about the said property or
facilities of the Hernando Sportsman’s Club, their representatives or
instructors.
Date: Signed:
=============================
Instructor Use ONLY ==============================
Date Class Attended Range
Date & Time
Paid:
Check # Money Order # Cash Amt $