Bersaglieri Shoot Entry
Please Mail to:
Birds Landing Sporting Clays
2099 Collinsville Rd  Birds Landing, CA 94512
or Fax to (707) 374-2814
Name:
 
Mailing Address:

City:      State:     Zip: 

E-Mail: 

Home Phone:               Daytime Phone: 

NSCA Member?    ( Yes   /  No  )

NSCA #:            NSCA Class: 

NSCA Concurrent 1:         NSCA Concurrent 2: 
Main Event ($99):    $
NSCA/CSCA Target Registration Fee ($6):    $
mandatory for NSCA members                                                                           

Total:    $

Payment Method:
Cash:       Check: 
Visa / MC # 
     Exp:      


Signature:_________________________________3 Digit Security Code: 


       Fill out form, print, then mail or fax to Birds Landing Sporting Clays for processing.