Name:________________________________________
Last First Middle (Full)
Last First Middle (Full)
Address:________________________________________
City:____________________ State: NC Zip: _________
DOB:_______________
DOB:_______________
Phone:_______________ Email:_________________
Course Requested:
( )NRA Basic Pistol $85.00 ( )NRA First Steps Pistol $45.00
( ) **NC Concealed Carry Handgun $100.00 ( ) Gun Rental $10.00
( ) **NC Concealed Carry Handgun $100.00 ( ) Gun Rental $10.00
(*NC CCH is NOT A NRA endorsed course)
Course Date Requested:____________________________
Disclaimer!
I understand that the use of firearms is inherently dangerous and that any unsafe use of them could result in death or serious bodily harm. As a prerequisite to enrollment, I agree to follow all safety rules set forth by my Instructor and that my willful disregard of them will result in my dismissal from class, without reimbursement of my tuition. I will not use drugs or alcohol preceding or during class.
I further agree to hold CSA LLC harmless for any accidents or injuries which may occur while in class or at the range. I agree to report any safety violations that I may witness to my Instructor immediately so that we can take immediate action to insure the safety of other students.
Please Do NOT Bring Your Firearm Into Class.
Please Leave Locked In Car Until Qualifying.
Please Leave Locked In Car Until Qualifying.
( )INITIAL here to indicate Disclaimer has been Read, Understood and Agreed.
Preregistration & Prepayment Required.No Refunds.
Payment Methods: Cash, Money Order, CC's via PayPal
Email: info@ccwofnc.com or FAX to: 336.229.5144
Questions: 336.270.9CCW (9229)
Mail To: CCWOFNC
1964 Stoney Creek Church Road
Burlington NC 27217
Questions: 336.270.9CCW (9229)
Mail To: CCWOFNC
1964 Stoney Creek Church Road
Burlington NC 27217