Pee Dee Land Trust · PDLT Clay Shoot Registration Form

Entry Type and Payment

Please Select Entry Type *	Quantity
$600 - Team
$175 - Individual - Adult
$100 - Individual - Youth (18 and under)
$25 - Non-Shooter Lunch

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

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:

*

Email/Cell Phone

Verify Email

2. Individual Youth or Non-Shooter

First Name

Last Name

Select attendee type:

*

Email/Cell Phone

Verify Email

3. Individual Youth or Non-Shooter

First Name

Last Name

Select attendee type:

*

Email/Cell Phone

Verify Email

Notes or Other Pertinent Information