(575) 840-7268 [email protected]

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HIGH POWER RIFLE FORM

The High Power Regional At Capitan

(Personal info and fees submitted must be filled out completely)

NRA Membership Number

Date of Birth

MM slash DD slash YYYY

Name(Required)

First Middle Name or Initial Last

Address

Street Address Address Line 2 City State ZIP Code

Email(Required)

Phone

Classification

HM High Master

M Master

EX Expert

SS Sharpshooter

MK Marksman

UNCL Unclassified

CATEGORY

Please check the category box that applies to your category

Civilian

Service

Senior

Woman

Police

Reserve

National Guard

Mid Range Classification

Rifle Type

Match Rifle

Service Rifle

600 Yd. Match Quantity

Price: $25.00

Quantity

Please place a 1 in the Quantity Field for the Match/Matches you want to shoot

Regional Quantity

Price: $55.00

Quantity

Please place a 1 in the Quantity Field for the Match/Matches you want to shoot

Leg Match Quantity

Price: $25.00

Quantity

Please place a 1 in the Quantity Field for the Match/Matches you want to shoot

Date

MM slash DD slash YYYY

Total

Please make sure that the total match fee is the correct amount for the Matches you want to shoot

Credit Card

Card Details

Cardholder Name

Download and print a Hard Copy of the schedule and application

click on the form below

Club President Bill Rodolph

(575) 840-7268

President Email

[email protected]

Range Location

US Hwy 380 is 3 miles east of Capitan, NM.

Want to Join The Club?

Go to our membership page and sign up or send us a message on our contact page.