2023 Indiana State Junior High Power Championship Registration Form

2023 Indiana State Junior High Power Championship

June 24, 2023 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 2023):  ______

Address:_________________________

City: _____________________        State:             ZIP: _________

Club Affiliation: ___________________________________

Email:  ________________________

For Junior Participants; Lunch is free.  I want a free lunch:  ___ YES          ____ NO

Additional lunches for parents, sponsors and spectators @ $11.00/each;   # _____

For Junior Participants; an event T-shirt is free.    Size (S, M, L, XL, XXL)  ____

Additional T-shirts for parents, sponsors and spectators @ $12.00/each:

Small _____   Medium _____   Large _____   X-Large ______   XX-Large _____

For additional information, contact Larry Beardsley at FWRRHPDirector@aol.com