Student Registration

This page serves as a student registration form intended solely for collecting information. Please note that submitting this form does not automatically enroll you in a class or process any payment for a class. It is a preliminary step to gather the necessary details for potential participation. Students typically are requested to fill this form out at an instructors request.

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Date:

First Name:

Last Name:

Address – (Include Unit Or Apt. Number If Applicable)

City, State & Zip Code:

Phone Number:

Email:

Date of Birth (MM/DD/YYYY)

Emergency Contact Name:

Emergency Contact Phone Number:

Pertinent Medical Info:

Type of Firearms Class:

Firearms Experience:

By submitting this form, you acknowledge and agree to the terms of a hold harmless agreement and liability waiver. You understand that participation in firearm training involves inherent risks, and you voluntarily assume all responsibility for any injuries, damages, or losses that may occur. You further agree to release and hold harmless the instructor, facility, and any affiliated parties from any claims, liabilities, or expenses arising out of your participation in the class. This acknowledgment and waiver are binding upon your submission of this registration form.

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