YAVAPAI FIREARMS ACADEMY, LTD.
APPLICATION FOR TRAINING

1. Please reserve _______________ space(s) for me in the class(es) indicated:

Date: ____________________ Date: __________________

Location: _________________ Location: ___________________

Weaponry: ________________ Weaponry: _________________

2. I enclose my deposit of $300 per space. I will pay the balance of my tuition upon registration. (Please make checks payable to YAVAPAI FIREARMS ACADEMY, LTD.) I understand that if I must cancel out of a class I will receive a full refund if I give at least 45 days notice. If I give less than 45 days notice I will forfeit my deposit. Payment in full is due at the course start.

3. I agree to abide meticulously by all safety procedures required of me and I understand that my instruction may be terminated at any time during the course if I fail to cooperate with safety requirements. I further agree to sign a statement releasing YAVAPAI FIREARMS ACADEMY, LTD. from responsibility for any injury I may sustain during the training program.

4. I agree to sign a sworn statement that I have never been convicted of any crime, at any time, in any jurisdiction.

5. In signing this application, I certify that I will be at least of sufficient legal age at the time of the class to possess the firearm, or will be accompanied by my parent or legal guardian.

NAME (Please print) __________________________________________________

Address ____________________________________________________________

City ___________________________ State ________ Zip _________

Telephone __________________________

(Business phone) __________________________

Email __________________________

Make, model and caliber of weapon you plan to bring

__________________________________________________

Signature ___________________________________

Please return completed application to: YAVAPAI FIREARMS ACADEMY, LTD.
PO Box 27290, Prescott Valley, AZ 86312
Phone (928) 772-8262

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