Thunder Valley rifle Range



Camp Blanding Rifle Range

Match Registration Form

Advertised Date of Sanctioned Target Match: January 21st-23rd, 2011

Location of Match: Camp Blanding, FL

Only bring firearms you are competing with, NO Carrying concealed on military installations

Name of Competitor: ______________________________________________________________

Address: _________________________________________________________________________

City: ________________________________ State: ______________ Zip: ____________

Phone: ( _____ ) _____-_____________ Fax: ( _____ ) _____-_______ Email:______________________

January 21st and 22nd, 2011

Which Class Will You Be Competing In: Heavy _____Light ____ Hunter ____Any other Class ____

(Any other class means any rifle caliber but a .50 caliber; it is the same course of fire as the .50 caliber)

January 23rd, 2011

Multi Record Fire Range (pop-up targets) .223/5.56 up to .7.62/.308, Handgun 9mm .40cal and 45ACP

Will you be shooting the MRFR course of fire? Number of entries?___

Will You Be Sharing Guns & Equipment with other Competitors: Yes______ No______

If Yes, Who Will You Be Sharing With? ______________________________________________________

What equipment will you be sharing? ____________________________________________________________

Are You A Current Member of NCSA, Ltd? Yes__ No__ Membership Number: ______Expires: __________

Amount of Money Enclosed: Number of Long Range Classes x $60 each = $ _________

MRFR Entry, Number of Entries X $60 rifle and handgun included each =$__________

Total _________

Practice MRFR entries will be $20 per practice and be signed up for at the event

Note: Each class of competition a shooter competes in will require an additional payment of a match fee.

Make Checks Payable To: North Coast Shooters Association, LTD (NCSA, LTD)

Mail To: North Coast Shooters Association, LTD , P.O. Box 364, Millersburg, Ohio 44654

The cutoff for entry into the match is 3PM Friday the sight in day.

By submitting this entry form to the Match Director at least two weeks in advance of the scheduled match, you will help the match host accomplish many of the jobs He/She has to accomplish before any match can proceed.

Signature of Competitor: ________________________________ Date: _____________________

You must be a member of NCSA, Ltd or join to participate For our insurance to cover you.

Each competitor is required to sign a Release of Liability form at the time of rifle inspection in order for this form to be accepted. Revised 12/20/2010

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