PICK A DATE

Saturday, May 4, 2013

STUDENT CONTACT INFORMATION

First name:

Last name:

Address:

City:

State:

Zip:

Phone:

email:

I have read and agree with the  waiver  (please print and bring to class)

Please let us know your handgun shooting experience level and the type of handgun you will be using (at the shooting range, we will put students into groups based on experience, and we shoot revolvers and semiautomatic pistols in separate groups):

experience beginner intermediate experienced   handgun type revolver semi-automatic

Additional names to be registered:

experience beginner intermediate experienced   handgun type revolver semi-automatic

experience beginner intermediate experienced   handgun type revolver semi-automatic

experience beginner intermediate experienced   handgun type revolver semi-automatic

experience beginner intermediate experienced   handgun type revolver semi-automatic

subtotal ($95 per student)

Comments, notes or questions?

Please let us know if you have any questions, if you have special needs, or if there is anything else you'd like to tell us.

If anyone attending the class with you will be sharing the same handgun, please tell us so that we don't schedule you to shoot in the same group at the same time.

HANDGUN RENTALS

We prefer that you bring your own handgun (in good working condition) to the firing range, along with 150 rounds of ammunition.

We can supply a limited number of handguns for a $15 fee. If you rent a handgun, you must bring 150 rounds of your own ammunition.

If you do not reserve a handgun with your order, it may not be available on the day of the class.

If your own handgun is unsafe or is not working properly, you will need to rent one of ours or you will not be able to complete the course. Delays because of handgun problems will inconvenience all the other students in your group. Please — clean and test your handgun and perform any necessary maintenance on it before you come to class.

GLOCK 19 — 9mm

GLOCK 23 — .40 S&W

Ruger P95D15 — 9mm

Ruger P944 — .40 S&W

Ruger KSP-321X— .357

Ruger KSP-831X — .38 Special

subtotal ($15 per rental)

PAYMENT INFORMATION

Total

Coupon code

I will be paying with:

Check/money order

Card number:

Name on card:

Expiration date (mm/yy):

Security code:

BILLING INFORMATION

If your billing address is the same as the information above, you don't need to fill out this section.

Address:

City:

State:

Zip:

If paying by check or money order, please send your payment to.

Straight Creek Enterprises
P.O. Box 339
Georgetown, Ohio 45121

Thank you.