DCWC Family Shooting Camp Application Form

Name:

Address:

Email:

Home Phone: Cell Phone:

Youth Section:

Camper 1: Male/Female Age: Height: Weight (if less than 100 lbs):

Camper 2: Male/Female Age: Height: Weight (if less than 100 lbs):

Camper 3: Male/Female Age: Height: Weight (if less than 100 lbs):

Participating Parent Section: (Parents are encouraged to shoot)

Parent 1: Male/Female Height: Weight (if less than 100 lbs):

Parent 2: Male/Female Height: Weight (if less than 100 lbs):

If parent(s) are not participating, how many will be present (circle answer): 1 2

Please describe any participant’s prior shooting experience if they have had such on the back of this form. No experience is required for participation. This is for planning purposes.

Price: $15 per youth and $25 per participating (shooting parent).

List total amount enclosed: $

Send this form and check (made payable to Durham County Wildlife Club) to:

Doug Ericson

13132 Ashford Park Drive

Raleigh, NC 27613

Must be received on or before September 13^th 2008.