REQUEST FOR INSTRUCTORS / RANGE SAFETY OFFICERS
Complete this form in order to notify your Council or District Shooting Sports Coordinator team of an upcoming shooting event for your unit.
It will automatically send an email with all of the information you provided to the appropriate team and yourself.
This is meant to initiate communication between you and the DACSS team, so that any necessary arrangements can be made.
CONTACT INFORMATION

Name:

Phone:     Phone Ext.:     Email Address:

District:     Type:     Unit #:

ACTIVITY INFORMATION

Date (yyyy/mm/dd):         Time (hh:mm):    Start       End

Number of Adults Shooting:       Number of Youths Shooting:

Shooting Disciplines (Check All That Apply)

  Rifle        

  Archery        

  Home Firearm Safety        

  Shotgun        

  Muzzleloader        

  Range Safety Officer        

  Pistol (Venture Only)        

  BB / Airsoft Gun        


Activity Location

Facility Name:     Phone:

Address:     City:     Zip:

Facility Reservation Confirmed:   Yes     No

MISCELLANEOUS INFORMATION

Additional Instructors Welcome?   Yes     No

Additional Instructor Meals Provided?   Yes     No

Additional Comments: