Contact Details
Course Requested
Course Date
First Name
Last Name
Date of Birth
Gender
Male
Female
Address
City
State
Zip
E-Mail
Home Phone
Work Phone
Cell Phone
Weapon Details
Primary Weapon
Make/Model
Caliber
Secondary Weapon
Make/Model
Caliber
Strong Side
Right
Left
Both
I Will Bring My Own Ammo
Yes
No (I need to order ammo)
Background Information
In order to assure that we only train law abiding citizens we request some basic information to verify your identity. This information will never be used or sold to any third party. Thank you for your understanding.
I Will Send a Copy of the Requested Documents by:
Scan and E-Mail
Fax
Mail
Drivers License
I Have Attended a Shots Ranch Class Within the Last 2 Years and Provided Credentials
Status
Responsible Citizen
Active Military
Active Law Enforcemnet
Active Security
Do you have a CCW?
I have a CCW License
This is My Initial CCW Class
I Do not have a CCW
CCW State:
CCW Number:
CCW Expiration:
I will send a "Statement of no Criminal History" from local law enforcement agency
Employer
Position/Rank
Supervisor Name
Supervisor Phone
Agency Name
ID Number
Terms & Agreements
By Typing your Initials Below, You Understand and Agree to the Following:
That the credentials enclosed meet the requirements as outlined by SHOTS RANCH LLC. and that I must positively identify myself as the same person cerifified in the credentials for enrollment.
That the SHOTS RANCH LLC. operations depends upon the careful control of deadly weapons by each participant; therefore, I understand that my instruction may be terminated at any time during the course if my conduct is not deemed satisfactory at the sole discretion of the staff.
That I will abide meticulously by any and all safety procedures required at SHOTS RANCH, and I agree to sign a statement releasing SHOTS RANCE LLC. from responsibilities for any injury that I may sustain during the course of the training program.
I will be at least 18 years of age at the time of my class
OR
will be accompanied by my parent or guardian.
CANCELLATION POLICY:
I understand that if class is cancelled, my deposit is fully refundable. If I cancel at least 60 days prior to the first day of class, 1/2 of my deposit is refundable
OR
the full deposit can be applied to hold another availabel class. If I cancel with less than 60 days before the first day of the class, my deposit is totally
NON-REFUNDABLE
, however; 1/2 of my depost can be applied to hold another available class.
The total of the tuition and the ammunition will be paid in full prior to the beginning of class. Tuition financing is available. Call for details.
Sign & Date
Signature
(Your typed name will serve as your legal signature.)
Date (MM/DD/YYYY)
Your Application ID (SAVE THIS NUMBER)
GZTRWF