20167 Clays for a Cause Registration form.pdf
(1140 Butcher Rd., Fenton Twp)
9am Check In & Breakfast | 10am Shotgun Flight Lunch & Awards to Follow Schedule may be adjusted to accommodate more shooters registered shooters will be notified
Shooter Registration Form Contact Person: Circle one: Team / Individual
# of team members: 4 / 6 ( if teams are not 4 or 6, additional shooters will be added to complete team)
Telephone:
Email Address:
Address:
Mobile: City:
State:
Zip:
Fax:
Shooter Names, required by Friday, May 26, 2017
Please circle one per line
Shooter #1:
Telephone:
Email:
Youth/ Adult
Shooter #2:
Telephone:
Email:
Youth / Adult
Shooter #3:
Telephone:
Email:
Youth / Adult
Shooter #4:
Telephone:
Email:
Youth / Adult
Shooter #5:
Telephone:
Email:
Youth / Adult
Shooter #6:
Telephone:
Email:
Youth / Adult
$50 Registered and paid by March 31st | $60 registered and paid by May 19th | $75 day of Includes: 1 round of target shooting (50 targets), Breakfast, lunch, games, awards ceremony Ear and Eye protection required, shooter must provide their own 12 or 20 Gauge Shot Guns only -provided by shooter Ammo may only be 6,7,8 shot only 100 rounds recommended to shoot course, games & extras Limited ammo will be available for purchase at the event Day of event you will be able to participate in fundraising games and much more!
$50|$60 per shooter @ # shooters
Total amount to be charged/due (registration, donation):$
**The Salvation Army of Livingston County is a 501c3 | registration is not refundable Payment Options:
Payment Enclosed
Visa
MasterCard
American Express
Discover
Printed Name on Card:____________________________________________Signature_______________________________________________________ Card Number:___________________________________ _______
_ Exp. Date: ________________Security Code: ________________
Billing Address if different than above:________________________________City:____________________State: _____________ Zip _________________
Please register online www.SalvationArmyLivingston.org or fax or mail this completed form to: The Salvation Army of Livingston County, Attn: April Dertian P.O. Box 647, Howell MI 48844 | Tel: 517-295-4344 | Fax: 517-546-1983 | [email protected]
9am Check In & Breakfast | 10am Shotgun Flight Lunch & Awards to Follow Schedule may be adjusted to accommodate more shooters registered shooters will be notified
Shooter Registration Form Contact Person: Circle one: Team / Individual
# of team members: 4 / 6 ( if teams are not 4 or 6, additional shooters will be added to complete team)
Telephone:
Email Address:
Address:
Mobile: City:
State:
Zip:
Fax:
Shooter Names, required by Friday, May 26, 2017
Please circle one per line
Shooter #1:
Telephone:
Email:
Youth/ Adult
Shooter #2:
Telephone:
Email:
Youth / Adult
Shooter #3:
Telephone:
Email:
Youth / Adult
Shooter #4:
Telephone:
Email:
Youth / Adult
Shooter #5:
Telephone:
Email:
Youth / Adult
Shooter #6:
Telephone:
Email:
Youth / Adult
$50 Registered and paid by March 31st | $60 registered and paid by May 19th | $75 day of Includes: 1 round of target shooting (50 targets), Breakfast, lunch, games, awards ceremony Ear and Eye protection required, shooter must provide their own 12 or 20 Gauge Shot Guns only -provided by shooter Ammo may only be 6,7,8 shot only 100 rounds recommended to shoot course, games & extras Limited ammo will be available for purchase at the event Day of event you will be able to participate in fundraising games and much more!
$50|$60 per shooter @ # shooters
Total amount to be charged/due (registration, donation):$
**The Salvation Army of Livingston County is a 501c3 | registration is not refundable Payment Options:
Payment Enclosed
Visa
MasterCard
American Express
Discover
Printed Name on Card:____________________________________________Signature_______________________________________________________ Card Number:___________________________________ _______
_ Exp. Date: ________________Security Code: ________________
Billing Address if different than above:________________________________City:____________________State: _____________ Zip _________________
Please register online www.SalvationArmyLivingston.org or fax or mail this completed form to: The Salvation Army of Livingston County, Attn: April Dertian P.O. Box 647, Howell MI 48844 | Tel: 517-295-4344 | Fax: 517-546-1983 | [email protected]
