Range Activity Report



Range Activity Report

New Mexico Hunter Education Program

Date of Live Fire Program

Position Name Instructor # Station

Chief Range Officer

Range Officer 1

Range Officer 2

Range Officer 3

Range Officer 4

Range Officer 5

Range Officer 6

Range Officer 7

Range Officer 8

Name & Location of Range

Course of Fire:

Number of shotgun stations Number of firing points for rifle activity

Distance to target

Rifle Pellet Distance to backstop

Type target(s)

Rifle Pellet

Shotgun

IF AN INCIDENT OCCURS DURING YOUR CLASS,

PLEASE FILL OUT REVERSE SIDE

HEP 045 Rev 5/09

Hunter Education Incident Report Form

Type of Firearms:

Mfg. Model Cal./Ga. Action Type Serial #/I.D.

Type of Ammunition:

Manufacturer Caliber Gauge/ Shot Size .22 S,L,LR

Information of Range Utilized

Location

Description

Impact area

Sketch of Range:

Comments:

HEP 045 Rev 5-09

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