Register – 2011 Shoot for the Cure Charity Event!

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)

Event Time Selection

1. Choose event time: Saturday, November 5, 2011 10am - 2pm (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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