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    2012 ALBERTA Registration

    Uploaded by

    Greg Thaczuk
    1) This document is a registration form for the 2012 IPSC Alberta Provincial Championships taking place June 30-July 1, 2012 at Phoenix Indoor Range & Gun Shop Ltd. 2) It requests information such as the registrant's name, address, date of birth, division, category, classification, range officer status, and squadding preference. 3) Payment information is also collected, including early bird and regular registration fees, costs for extra banquet tickets, official match shirts, and options for payment by cheque or electronic payment.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    2012 ALBERTA Registration

    Uploaded by

    Greg Thaczuk
    28 views1 page
    1) This document is a registration form for the 2012 IPSC Alberta Provincial Championships taking place June 30-July 1, 2012 at Phoenix Indoor Range & Gun Shop Ltd. 2) It requests information such as the registrant's name, address, date of birth, division, category, classification, range officer status, and squadding preference. 3) Payment information is also collected, including early bird and regular registration fees, costs for extra banquet tickets, official match shirts, and options for payment by cheque or electronic payment.

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    1) This document is a registration form for the 2012 IPSC Alberta Provincial Championships taking place June 30-July 1, 2012 at Phoenix Indoor Range & Gun Shop Ltd. 2) It requests information such as the registrant's name, address, date of birth, division, category, classification, range officer status, and squadding preference. 3) Payment information is also collected, including early bird and regular registration fees, costs for extra banquet tickets, official match shirts, and options for payment by cheque or electronic payment.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    28 views1 page

    2012 ALBERTA Registration

    Uploaded by

    Greg Thaczuk
    1) This document is a registration form for the 2012 IPSC Alberta Provincial Championships taking place June 30-July 1, 2012 at Phoenix Indoor Range & Gun Shop Ltd. 2) It requests information such as the registrant's name, address, date of birth, division, category, classification, range officer status, and squadding preference. 3) Payment information is also collected, including early bird and regular registration fees, costs for extra banquet tickets, official match shirts, and options for payment by cheque or electronic payment.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    Buffalo Target Shooters Association


    A member club of the Alberta Provincial Rifle Association

    P.O. Box 394 @ #300, 8120 Beddington Blvd., N.W.


    Calgary, Alberta,T3K 2A8

    2012IPSCALBERTAPROVINCIALCHAMPIONSHIPSJune30July1,2012
    Sponsored by Phoenix Indoor Range & Gun Shop Ltd
    CoMatchDirectors:RickErickson/JoeBreslawski

    NAME:____________________________Address:_________________________________________________
    CITY:________________________Prov/State:_________PCode___________Phone#:_____________________
    Email:________________________________________IPSCICSAlias__________________________________
    DateofBirth________________________________
    Division:OPEN_____STANDARD____CLASSIC_______PRODUCTION____REVOLVER____MAJOR____MINOR____
    Category:JUNIOR____LADY____SENIOR____SUPERSENIOR____ OfficialClass:_____ORDeclaredClass:_______

    NOTE:ClassificationisyourcurrentIPSCAlbertaClassification.IfyoudonothaveaclassificationenterU[Unclassified]orG[GrandMaster]
    RANGEOFFICERSTATUS:RM___CRO___RO___STATS___HELPER___
    SquaddingPreference(name):____________________________________________________________________

    MembershipConfirmationContactEmail:________________________________________[outofprovincecompetitorsonly]
    Note:Confirmationofcurrentmembershipinhomeprovinceisrequiredpriortomatchregistrationclosingdateorcompetitorwillnotbeallowedtoshoot.

    Work/ShootSchedule:Work12day,Shoot12day. AllcompetitorsmustattendbothdaysunlesspermissiongivenbyMatch
    Director.Failuretodosowillmeanremovalfromthematch.

    Payment Information:
    MatchFee:Earlybird(ReceivedbeforeJune1,2012) Includes1banquetticket

    $150.00

    Juniorsreducematchfeeby$40
    ReceivedbetweenJune125

    $200.00

    ExtraBanquetTicket

    $40.00

    OfficialMatchshirt Size:S___M___L___XL___2XL___3XL___Guy
    $70.00
    $

    Donations:totheBTSAforimprovementstoourshootingfacilities

    AllshirtordersmustbereceivedbyJune1,2012

    Total

    NotesonShirtorder

    Pleasemakechequespayableto:BuffaloTargetShootersAssociation(SendtotheaddressaboveNO POST DATED CHEQUES


    ElectronicPayment[EMT]to:[email protected]:IPSCABPROV
    Iunderstandthatfromtimetotimepromotionalpicturesand/orvideosaretakenatmatches.IgrantpermissionformypicturetobeusedinIPSCAlberta,
    IPSCCanadapromotions,BTSA/APRA and/orIPSCAlbertaProvincialswebsite IDO/IDONOT DefaultIDO: I DO
    WithmyacceptancetoparticipateintheIPSCAlbertaProvincialChampionships,June30July1,2012,IherebyagreeandreleaseIPSCCanada,IPSCAlberta,
    Alberta Provincial Rifle Association, Buffalo Target Shooters Association, and all tournament organizers, officials, workers, other competitors and the
    sponsors from all liability which may arise out of any loss, damages, injuries or deaths while en route to, during participation, during the period of the
    tournamentorenroutefromthetournamentorwhileonpremiseswhereanyofthematcheventsorsocialactivitiesoccur.Ifullyacknowledgetherightof
    theMatchOrganizerstoterminatemyparticipationwithoutrefundofanytournamentfeesorothercostsuponfailureofminetocomplywithallrulesof
    IPSCandtherangespecifiedinthetournamentguidelineorwhichmaybelaterannouncedatthetournament.IfurtherstatethatIhavereadandacceptthe
    RangeRulesandthisreleaseandenterintoitfreelyonbehalfofmyself,heirs,nextofkin,executorsandadministrators.

    04/04/12
    Signature:_________________________ Date:______________________
    _____________________________DONOTWRITEBELOWTHISLINE____________________________

    Datereceived:_____________DateenteredinWSS:__________________RegistrationNo.______
    Cheque:__________Cash:__________EMT:__________

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