REGISTRATION FORM
2022 Indiana State Junior High Power Championship
July 16, 2022 at the Fort Wayne Rifle and Revolver Club
15715 Rupert Road; Harlan, IN
(See the Match Program for details)
Name: ________________________________ Age (As of 31 Dec 2022): _______
Address:________________________________
City: ____________________ State: IN ZIP: __________
Club Affiliation: __________________ NRA Classification_____________________
Email: __________________________
For Junior Participants; Lunch is free. I want a free lunch: ___ YES ___NO
Additional lunches for parents, sponsors and spectators @ $10.00/each; # ______
For Junior Participants; an event T-shirt is free. Size (S, M, L, XL, XXL) _________
Additional T-shirts for parents, sponsors and spectators @ $11.00/each:
Small _____ Medium _____ Large _____ X-Large _____ XX-Large _____
For additional information, contact Larry Beardsley at FWRRHPDirector@aol.com