United States Field Target  2006 National Competition -October 6,7,8 - Wolcott, CT

REGISTRATION FORM

Competitor:

Last name: ________________________   First name:________________________

Address:    ___________________________________________________________

City:          __________________ State: _________________ Zip:_______________

Phone #:     __________________email:_________________

Emergency contact name: ____________________________ Phone #: ___________

Division of competition:   PCP    PISTON   (circle one only)

Class of competition:    NOT APPLICABLE      HUNTER      STANDING     (circle not applicable if not shooting Hunter or Standing)

As of October 6, 2006
Are you a senior (> 64 years old)?    YES      NO

Are you a junior (<18 years old)?     YES      NO

Have you previously participated in a field target match at the state, regional or national level?  YES   NO

Airgun you will use: __________________ _____ Scope:________________________

Pellet:_________________________ Velocity: ____________fps

WLOPA limits airguns to 20 ft-lb or less pellet energy at the muzzle.  Targets are set to actuate with 4 ft lb or greater of pellet energy applied to the kill zone plate.

Please circle each complimentary meal that you will take at WLOPA and indicate additional guest meals required *

October 7:    Breakfast      Lunch               October 8:     Breakfast       Lunch

If you have any dietary restrictions, please specify :

Free air will be provided to all competitors.  Bring your own fill adapters.

Refunds will only be provided for registrants who cannot attend due to family, illness, or work-related issues.  Refunds will not be provided to registrants because of match rule application or any circumstance associated with conduct of the event.

Fees:                                                                                                                         Total

Match registration    $75 - before Sept 1   $ 100 - after Sept 1                    $ _____

Bob Zimmerman Signed Commemorative pellet box   $15                          $ _____

Total enclosed                                                                                                  $ _____

Do not send cash. Please make check payable to David Day and return to:

David Day

1102 N Benson Road

Fairfield, CT 06824

Upon receipt and processing of this form a welcome packet will be sent to the above address.

* Persons with guests not participating in the Nationals Match may also dine with the shooters.  A recommended donation of $10 per day for each guest is appreciated.