Registration & Membership Application - GSSF

1 Name:GSSF #:Street:Expires:City:State:Zip:Master Shooter? YES NOEmail:Date of Birth:New Address ?Phone: Alt. Phone: Match City, State and Date:Join:Guardian:Renew:Family:Fm Rnl:AMATEUR CIVILIAN ($30)AMATEUR GUARDIAN ($30) AMATEUR & MASTER SUBCOMPACT ($30) AMATEUR & MASTER HVYMETAL ($30) AMATEUR & MASTER ($30) AMATEUR & MASTER ($30) MASTER STOCK ($30) UNLIMITED All models allowed except G36,G42 & G43 - Please Specify _____Payment Information:CashCheckMoney OrderAmount: $Expiration Date: Registration & Membership Application Adult Female Junior Female Senior Super Sr. Challenger Junior Male Guardian Female PLEASE PRINT Match concludes when all registered competitors complete the match or we lose CHECK ALL APPLICABLE BELOWC ircle Model: 17 19 20 21 22 23 26 27 29 30 31 32 33 37 38 39 ORMemberships & Renewals 1 Year ($25) 2 Year ($50) 3 Year ($60) 5 Year ($95) Guardian New & renewal Special Recognition Categories (check all boxes that apply at no additional cost).

2 1 Year ($35) 2 Year ($60) 3 Year ($80) 5 Year ($125) Lifetime ($350) 1 Year ($25) 2 Year ($50) 3 Year ($60) 5 Year ($95) 6000 Highlands Pky, Smyrna, GA 30082 Phone: Fax: individuals present must sign a Liability Release at the match and agree to obey range and basic firearm safety Hours: Saturday 9am to 3pm Sunday 9am to 2pmPlease note, for matches in October - March, Registration hours are 9am to 2pm both Competitors must pick up labels during Registration hours. Competitors have the choice to compete on one or both days. For detailed information, online entry forms & match results visit Information - PLEASE READC redit vouchers will be issued to pre-registered competitors who did not attend the match.

3 Vouchers can be used for future Registration fees and/or Membership fees. There will be no cash refunds. 1 Year ($90) 2 Year ($160) 3 Year ($230) 5 Year ($350) Lifetime ($900)Last 3 Digits of Security Code (located on back): VISA / MC / Discover AMATEUR & MASTER COMPETITION ($30) 1 Year ($70) 2 Year ($140) 3 Year ($170) 5 Year ($255) (Under 18) (55 - 64) (65+) (Handicapped) (Under 18) 17 17C 17L 19 19C 20 20C 21 21C 22 22C 23 23C 24 24C 20 21 29 30 37 38 39 (11 rounds )26 27 29 30 31 31C 32 32C 33 34 35 37 38 39 40 4126 27 29 30 33 39 Amateurs can compete in up to 9 divisions.

4 Masters can compete in up to 8 are NOT accepted over the phone. All competitors are eligible to shoot in Master Divisions. 17 19 20 21 22 23 26 27 29 30 31 32 33 37 38 3929 30 36 39 MAJOR SUB (7 rounds only) Registration must be received no later than Noon Wednesday prior to the match date. #.