Clay

Please note: This form is to be used for on-line credit card payments only. The following are accepted: MasterCard, Visa, Discover. If you plan to pay by check, please click here for the mail-in registration form.

One Form Per Shooter *=Required

Prefix:

First Name:*

Middle Initial:

Last Name:*

Suffix:

Address:*

City:*

State:* Zip:*

County:*

Organization:

Email:*

Daytime Phone*

Evening Phone:

Please Check All That Apply:

I am participating as:*

Individual Team

I am a Farm Bureau Member

In addition to individual competition prizes may be awarded in the Trap Shoot or Sporting Clays for the following categories: Please check all that apply

Woman

Junior (18 & under)

Husband & wife

Old Timer (65 years & older)

Farm Bureau Member

Trap Shoot Doubles

Trap Shoot Two Man Doubles Team

Team Competition

Please Complete All That Apply:

Trap shoot

Persons at $30/person per 100 targets each ($35.00 after June 27)

Trap Shoot Junior (18 and under)

Persons at $25/person per 100 targets

Doubles Trap Shoot

Persons at $17.50/person

Sporting Clays

Persons at $45 per 100 targets ($50 per 100 targets After June 27)

Sporting Clays Junior (18 and under)

Persons at $40 per 100 targets