SR-1

Name________________________________

Street Address_________________________

City_________________________________

State_________________________________

Zip__________________________________

NRA#________________________________

Phone#_________________________________

Date of Birth___________________________ Email:____________________________________

Category: Civilian____ Service____ Woman____ Junior____ Intermediate Jr.____ Sub Jr.____ ROTC____ Collegiate____ Police____ Senior____ Nat'l Guard____ High School____ Reserve____ Special_________

Classification: High Master____ Master____ Expert____ Sharpshooter____ Marksman____ Unclassified____

Relay: 1st. Choice____ 2nd. Choice____

Highpower Rifle (Rule 19.5): Match Rifle____ Service Rifle____

Mid-Range (Rule 19.5.2): Any Rifle____ Match Rifle____ Service Rifle____ F-Open_____ F-TR_____

Long Range (Rule 19.5.1): Any Rifle____ Match Rifle____ Service Rifle____ Palma____ F-Open_____ F-TR_____

Tournament Date & Location____________________________

Registration Fee $__________________

Amount Paid $_________________

Signature______________________________

Mail To:

Chattahoochee Rifle Club

P.O. Box 9753

Columbus GA 31908