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REGISTRATION FORM
Please make checks or money orders out to the Valerie Flynn
.  Thank you!

Class Date on ______ / ______ / ______

Name(s):

NRA Basics of Pistol Shooting: Phase II

     $215 x #______ = __________

Total $__________  &  # ________ People

# _____________ Annie Oakley Specials?

CC Safety & Laws

    $100 x  #______ =__________
    (
    4 or more paying people $75 each)

Private Coaching

$45 x #______  = __________

Coaching Club - Bronze Membership
(upto 2 sessions per month)

    $75 x #______ = __________

Coaching Club - Silver Membership
(upto 3 sessions per month)

    $100 x #______ = __________

Address:

City

State

Zip:

E-Mail:

Phone Number(s):

Work / Home:

Cell:

Phone Number(s):

Work / Home:

Cell:

Other Notes:  _________________________________

______________________________________________

______________________________________________

Coaching Club - Gold Membership
(upto 4 sessions per month)

    $120 x #______ = __________

Mail Registration Form & Payment to:

Valerie Flynn
1151 Eagle Drive, #458
Loveland, CO 80537

Please list any other student(s) names:

 ________________________________________________

 ________________________________________________

 ________________________________________________

 Questions?  Contact: (970) 556-3806 or via e-mail classes @ selfdefenseguns.com

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