2011 Fun Hunt and Trap Shoot Registration

March 19, 2010 - Saturday (Rain Date: TBD)

FORM INSTRUCTIONS: Complete the registration form online, click the [Print Registration] button to print the form, then mail the form with your check enclosed to be received no later than March 11, 2011.

Your Name:

Your Phone Number:

Your Email Address:

Your Address:

I am registering for 1234 full bird/trap rounds. Enclosed is: $45$90$135$180.

I am registering for 01234 bird field-only runs. Enclosed is: n/a$35$70$105$140.

I am registering for 01234 additional lunches. Enclosed is: n/a$5$10$15$20.

Names of additional attendees (if any):

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Make Check Payable to: Western Illinois NAVHDA Mail to: Rich Runge, P.O.Box 322, Andalusia, IL 61232 Questions: Rich Runge 309.798.5115 or Jeff Henke 563.299.4435