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

Class Date on ______ / ______ / ______

Name(s):

CC Safety & Laws

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

NRA Basics of Pistol Shooting
Annie Oakley Special applies!

Tuition: 3 payments of $94.99 each x #________  =


Class Total $__________  &  # ________ People

# _____________ Annie Oakley Specials?


Private Coaching

$50 x #______  = __________

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

    $75 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 3 sessions per month)

    $100 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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