Dues & Registration:
Name:
Address:
City:
State/Prov:
N-SSA #
Zip/Post. code:
Phone:
Fax:
E-mail:
Please register for the following activities.
$45.00
N-SSA DUES (before 12/1)
N-SSA DUES (after 12/1)
$48.00
Patches: 4 shoots @ $2.00 ea.
$ 8.00
Trailer Fee, annual fee for parked trailers
$10.00
Cannon Fund
Spring National:
Musket
50 yd
100 yd
Agg
Carbine
Br. Loader
TRAILER INFO:
Revolver
25 yd
Type:
Musket/Carbine
Grand Agg
Pop-up
Sp. Nat Indiv. Total
5th Wheel
Fall National:
Motor Home
Hard shell
Other
Manufacturer:
Description:
Fall. Nat Indiv. Total
Length, ft
Individual Matches, $1.25 ea.
#
Age, yrs
General condition:
Extra Team Matches: (team captain enter only)
Excellent
Event
Mortar
Good
Spring National,
$15
$30
Fair
Fall National,
Poor
Spring Regional,
- - -
$12
Describe Problems:
Msn. Dxn, 100 yd,
Msn. Dxn, 200 yd,
Fall Regional,
Total Extra Team Matches
Grand Total: (total of all blue boxes)
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