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Date: ______________

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NAME __________________________________________________________ ADDRESS _______________________________________________________ City, State, Zip ___________________________________________________ PHONE # ____________________ E-Mail _____________________________

(Suggested donation Members pay only $10 per relay.) (Suggested donation for non-members $15 per relay.)

MEMBERSHIP New Renewal ________ $20 Donation for Individual Relays ______ X ________ ________ Family Memberships available: ______ ________ ________ Spouse additional $10 ______ ________ ________ Jr. Shooters $5 (12-17 yrs old) Total ________

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RELAY ______ RELAY ______ RELAY ______ RELAY ______ LANE ______ LANE ______ LANE ______ LANE ______ NAME ____________________________________

Participant in the FOCP POP-UP SHOOT.

CASH TOTAL: ________________ CHECK Make checks payable to Friends of Camp Perry

THANK YOU FOR JOINING US AND HAVE A NICE DAY!

Friends of Camp Perry Pop-Up Shoot Registration

❑ Rifle ❑ Pistol

RECEIPT www.friendsofcampperry.org