CARNARVON PISTOL CLUB INC.

I.P.S.C. LEVEL 2 OPEN

28 & 29 SEPTEMBER 2002

ENTRY FORM

NAME:   …………………………………………………

ADDRESS:     ……………………………………………

…………………………………… Post Code:      ………

PHONE: (W) ………………. (H) …………………

IPSC No. ………….. Grade ………… Club …………...

Tick as appropriate:

ÿ       MINOR                                  ÿ       MAJOR

ÿ       AUTO                                     ÿ       REVOLVER

ÿ       OPEN                                     ÿ       STANDARD

ÿ       LADY                  ÿ       VETERAN          ÿ       JUNIOR

Do you wish to nominate yourself as a RANGE OFFICER in the Carnarvon Level 2 Open?        ÿ       YES

Please indicate if sharing a pistol with another competitor

ÿ YES        Sharing with ……………………………… (name)

I hereby agree to abide by all rules and regulations set by the IPSC Edition 14 Rule Book and all rules and bylaws set by the Carnarvon Pistol Club Inc.  I also agree to act in a sportsmanlike manner and show consideration to my fellow competitors and officials during this competition.

SIGNED: ……………………………….

PLEASE SEE REVERSE FOR ENTRY FEES APPLICABLE

ENTRY FEE’S

MATCH PACKAGE BEFORE THE 7^th SEPTEMBER

Includes nomination fee and all meals Pay by the 7^th and receive the Early bird payment special  ADULT……….$120.00

                                    JUNIOR……….$85.00

OR

Late entry or on the day price after the 7^th

                        Please indicate the number of meals required

Nomination:    ADULT           $80.00             r       $……….

                        JUNIOR         $60.00             r      $……….        

Breakfast          (per day)          $6.00               r       $……….        

Lunch               (per day)          $6.00               r       $……….        

Dinner              Sat night           $15.00             r      $……….        

Dinner              Sun night          $20.00             r       $……….        

                        (Presentation)

                                                                        Total    $……….

CHEQUE ENCLOSED r               WILL PAY ON ARRIVAL r

RETURN ENTRY FORMS TO P.O BOX 752 CARNARVON W.A 6701

OR FAX TO (08) 99411897

Contact Shane Aylmore wk (08) 99411185, hm (08) 99418809 e-mail: saylmore@fish.wa.gov.au , Ray Smith (08) 99412757 e-mail: rak@dodo.com.au

There will be a complementary BBQ on Friday Night for those that arrive in town. Registration Saturday from 07:30am onwards briefing at 08:30am shooting starts at 09:00am sharp.

The Range is sign posted and is located approximately 5 km south of Carnarvon on the western side of North West Coastal Highway (look for the IPSC target)