Student Registration

1. First & Last Name(required)
2. Street Address(required)
3. City(required)
4. State(required)
5. Zip Code(required)
6. Primary Phone(required)
7. Secondary Phone
8. Email(valid email required)
9. How did you hear about Proactive Shooters?(required)

Class Date Selection

1. Course Date Choose class date: Sunday, April 29, 2012 9am - 5pm Saturday, May 19, 2012 9am - 5pm Saturday, June 16, 2012 9am - 5pm Sunday, July 22, 2012 9am - 5pm Saturday, August 18, 2012 9am - 5pm (required)

Person to Notify in Case of Emergency

1. Name(required)
2. Primary Phone(required)
3. Secondary Phone
4. IMPORTANT - You must click "SUBMIT" to send your registration. You will then be redirected to the "Pay Now" button to make your payment with your Visa, Mastercard, Discover, American Express, electronic check or PayPal account. If you wish to pay in another manner, you may do so by contacting our offices to make arrangements.

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