Thank you for registering for Refuse to be a victim

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We look forward to seeing you on April 30, 2016 at the Blue Ridge Cherry Valley Rod and Gun Club!

Before we can finish processing your registration we would like to get to know the participant a little better. Please fill out the form below and click “Send” when you are done. This will help us properly prepare for your arrival and insure that you get the most out of this instructional shooting clinic.

If you have any additional questions please send email the event organizer.


Your Full Name (required)

Your Address (required)

Telephone Number (required)

Your Email Address (required)

Participants Age (required)
(Those under 18 must be accompanied by a parent or guardian)
10 to 1314 to 1718 and over

Date of Birth (required)

NRA Member ID (optional)

How did you hear about Refuse To Be A Victim at the Blue Ridge Cherry Valley Rod and Gun Club?

Special Requirements / Anything you think we should know?