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2. NOTE: You must attend the First Class and Drill.

4. First Name*
5. Last Name*
6. Date of Birth*
8. Address*
10. City*
11. State
12. Zip*
14. Home Phone*
15. Cell Phone*
17. Email Address*
19. Drivers License*
20. License State*
22. Have you ever been arrested? If yes, please explain:*
24. Please list any medical conditions that would prevent you from participating in certain events:
26. Comments or questions:
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field