DATE: ___/___/_____

Time: From ___________ To __________

Estimated Participation: ___________________ Open to the public: YES_____ NO _____

Your Name: ________________________________________

Address: ________________________________________


Phone & E-mail: __________________________ ______________________________


  1. All requests are subject to WSC Board approval.
  2. Submit your request at least one month in advance to allow for discussion & approval.
  3. All firearm events MUST have at least one (1) NRA Certified Club Range Officer present who is dedicated to your event.
  4. All participants must be signed in and have a signed liability wavier held by the ROS at the event.
  5. No fee can be charged for use or participation in a range event. However donations are permitted.
  6. All monies in excess of the actual cost of the event will be deposited with the WSC Treasurer and a simple balance sheet will be provided by the event sponsor.
  7.  E-mail this completed form to:bocosully@me.comquestions call: 603-253-5403

Requested By: ____________________________________ Date: ___/___/_______

CLUB USE: Received: __/___ / ___ Approved: YES ______ NO _____

Sponsor notified: __/___/___ By: ____________________

Calendar Updated:  ________

Issue: 1.3

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