Jr Olympics 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 ($79):    $
Mandatory for NSCA shooters - NSCA/CSCA target registration fee ($6):    $
Optional Donation:    $
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.