2010 ARIZONA SMALLBORE RIFLE & SMALLBORE HUNTER RIFLE SILHOUETTE
STATE CHAMPIONSHIP MATCHES
OCTOBER 2nd and 3rd, 2010
PLEASE COMPLETE AND RETURN BY SEPTEMBER 25, 2010
NAME:___________________________________
ADDRESS:_____________________________________________________________
CITY:___________________________________________________
STATE:________
ZIP:____________
PHONE NO. : (      ) _____________________ EMAIL ADDRESS:____________________________________
JUNIORS/SENIORS: Date of birth:
Month________
Day______
Year_______
ASR&PA MEMBERSHIP NO._______________________________
Exp. Date_________________(Send copy)

CLASSIFICATION (CIRCLE ONE)
SMALLBORE RIFLE
MASTER
AAA
AA
A
 B
SMALLBORE HUNTER RIFLE
MASTER
AAA
AA
A
 B

SPECIAL AWARDS (CIRCLE ONE IF APPLICABLE)
SENIOR (60-69 YEARS)
SUPER SENIOR (70 YEARS & UP)
WOMAN (NON-JR., NON SENIOR 21 -59 YRS.) 
JUNIOR (18-20 YRS)
 INTERMEDIATE JUNIOR (15-17 YRS)
SUB JUNIOR (14 YRS. & YOUNGER) 

MATCH FEES (DEADLINE Spetember 24 FOR DISCOUNTS)
FIRST RIFLE……...………………………………………....................…
$85.00 ______________
SECOND RIFLE………………………………………............................
$25.00 ______________
JUNIORS, INTERMEDIATE, SUB-JUNIORS….....................……...
$35.00 ______________
SECOND RIFLE (JUNIORS)……….........................…………………..
$20.00 ______________
EARLY ENTRY DISCOUNT…….............................…………………
(-$10.00) ____________
ASR&PA DISCOUNT…………….............................………………….
(-$5.00) _____________
You must send a copy of your ASR&PA card to get this discount.

Please mark for the dinner.
Do you plan to attend the dinner after the match?  Yes____No____
If yes, will you have guests and how many? ($15.00 ea x _____)
______________
  

TOTAL AMOUNT SUBMITTED…………………………………..……..______________
FOR SPECIAL SQUADDING REQUESTS, SHOOTING PARTNERS MUST SUBMIT THEIR ENTRIES AT THE SAME TIME.
SQUAD ME WITH:______________________________________________________

MAIL ENTRIES TO:

Jerry Webster

2115 E. Rosemont Drive

Pheonix, AZ 85024

Make checks payable to: Hassayampa Rod & Gun Club
Include copies of your NRA card, ASR&PA card, and the appropriate page(s) of your classification book