Kansas Approved Concealed Carry Handgun Course

Pre-Registration for Aug.  21  2010 CCL Renewal Sept. 7 / 14/ 21/ 28

This mandatory 8-hour course will be $95.00 per person  Participant Equipment Required: ANY Handgun,

New Ammunition (50rds) NO RELOADED AMMO! Eye&Ear protection, Pens, pencils and notepaper.

NO LIVE AMMO IN THE CLASSROOM! Please print, sign and return this form with a $25.00 deposit

(balance due the day of class) or Full Payment. Deposit is NON-REFUNDABLE.

Name:_________________________________________________________________________________________

Address:_______________________________________________________________________________________

 Phone:________________________________________ Email:__________________________________________

If this class fills up, circle the class of your choice:   8hr Qualifying Course           2 Hr. CCL Renewal ($25.00)

Special request date:_____________________  Special Needs or Physical Limitations?______________

Pistol Shooting Experience (Circle One):             None                     Limited              Experienced 

Your signature on this application is considered proof of your acceptance of the following terms and conditions: I agree that by signing this application

that I release MC's Sporting Arms & Accessories and its Trainers of any responsibility for any injury that I may sustain during this course, I certify that

I am at least 21 years of age, a resident of Kansas, a law abiding citizen without a felony record, and that I may legally use and possess firearms,

I understand and agree that the safety of the class depends upon my complete compliance with all firearm safety rules and that I will

abide by all such rules. I understand that my participation may be terminated, without refund, if I do not conduct

myself in a safe and responsible manner.