First Name Last Name Address Line 1 Address Line 2 City State —Please choose an option—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennslyvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip/Postal Code Phone Email Are you under indictment or have you ever been convicted of a felony? YesNo Are you now or have you ever been under treatment for any mental disorder? YesNo I agree to abide by all safety rules and range procedures required by Shoot-N-Iron Practical Shooting Academy. I release Shoot-N-Iron Inc. from any responsibility for any injury that may be sustained during the training program. I certify that I am at least eighteen years of age and or will be accompanied by a parent or Guardian. For Police Training, please submit on Department Letterhead stating that you are employed with that agency. (This applies to Law Enforcement Officers only).
