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PDLT Clay Shoot Registration Form
Entry Type and Payment
Please Select Entry Type
*
Quantity
$600
-
Team
0
1
1
$175
-
Individual - Adult
0
1
1
$100
-
Individual - Youth (18 and under)
0
1
2
3
3
$25
-
Non-Shooter Lunch
0
1
2
3
3
Please Select One of the Following
*
I Am Registering Additional Individuals (Under 18) or Non-Shooters **Please Note: For Additional Adult Individuals, You Must Fill Out a New Form
Yes
No
Team Information
Contact Information
1. Captain - Contact Information
Name
*
First Name
Last Name
Email/Cell Phone
*
Verify Email
*
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Team Members - Contact Information
Please Note: If all team members are not identified at time of registration, please send name, email, and phone number of each prior to April 28th.
2. Team Member
First Name
Last Name
Email/Cell Phone
Verify Email
3. Team Member
First Name
Last Name
Email/Cell Phone
Verify Email
4. Team Member
First Name
Last Name
Email/Cell Phone
Verify Email
Individual Youth or Non-Shooter - Contact Information
1. Individual Youth or Non-Shooter
First Name
Last Name
Select attendee type:
*
select one
Youth Shooter
Non Shooter / Lunch Only
Email/Cell Phone
Verify Email
2. Individual Youth or Non-Shooter
First Name
Last Name
Select attendee type:
*
select one
Youth Shooter
Non Shooter / Lunch Only
Email/Cell Phone
Verify Email
3. Individual Youth or Non-Shooter
First Name
Last Name
Select attendee type:
*
select one
Youth Shooter
Non Shooter / Lunch Only
Email/Cell Phone
Verify Email
Notes or Other Pertinent Information
Add 3% to my total amount to help cover the payment processing fees