Black Diamond Gun Club, Inc

                                                             Basics of Pistol Shooting
                                                         Registration Form

Please read and fill out this form carefully.  Please print legibly.  If you have any questions
concerning this form, please call (253)315-2672

*** Registration Fee is $100.00, due at time of registration.
_____________________________________________________________________________

Registration Fee Policy:  Please understand that Black Diamond Gun Club, Inc. purposely keeps classes
small for the benefit of their students, therefore no reservation will be held for you and you will not
be registered for the class until the fee has been received.

Refund Policy:  If your class is canceled, your registration fee is fully refundable.  If you choose to cancel
your attendance at least 14 days prior to the first day of class, half of your registration fee is refundable,
OR the full fee can be applied to hold another available class slot.  If you cancel your attendance less
than 14 days before the beginning of your class, your registrations fee is NON-REFUNDABLE, OR half
of your fee can be applied to another available class.

_________________________________________________________________________________________________________________

                                                                Personal Registration Information

Name ______________________________________________________________________________

Address ___________________________________________________________________________

City ___________________________________State_______________Zip Code_______________

Daytime Phone ________________________________Evening Phone _______________________

Email Address _____________________________________________________________________

Concealed Pistol License # ________________________Expiration Date ________________

_________________________________________________________________________________________________________________

                                                      Registration Payment Information

Date ___________________________________

Enclosed is $_____________________________

Payment Type: Check _____________________

              Other ______________________________________________

Referred by ______________________________________________________________

                              Please complete and return with enclosed registration fee to.
                          Write checks to the order of Black Diamond Gun Club and mail to:

                              
                Do Not Send Women's Pistol Forms and payment to the Black Diamond Gun Club     
        
                                                   Jim Locke, Basic Pistol Shooting
                                                   27004 211th Ave SE
                                             Covington, WA 98042-6107
                                                      (253)315-2672

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