First Name

Last Name

Address

Address 2

City State Zip

Phone Number

E-Mail Address

Weapon Type Semi-Auto Unknown Revolver Caliber .22 .32 .357 .38 .40 .45 Other Experience Level Beginner Occasional Shooter Regular Shooter

Date Requested (mm/dd/yy) Over 21? SC Resident? Military SCDL or ID?

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 CWP 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 CMH Consulting L.L.C. 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 he can take immediate action to insure the safety of other students.

I have read, understand, and agree to the terms of the class disclaimer

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