Zion Security Enrollment

ZION SECURITY

2010 TRAINING APPLICATION

PLEASE COMPLETE A SEPARATE FORM FOR EVERY MEMBER OF YOUR FAMILY THAT IS TAKING THIS COURSE. ALSO IF YOU ARE APPLYING FOR MORE THAN ONE COURSE USE A SEPARATE FROM FOR EACH COURSE.

COURSE REQUESTED: _______________ DATE OF COURSE: _____________

COST OF THE COURSE: _____________ AMOUNT OF DEPOSIT: __________

POLICY FOR DEPOSITS AND REFUNDS: READ CAREFULLY!

The Church Security Course deposit is 100.00 per person, the balance due upon arrival. All other deposits for any other course will be 50.00 per person, balance due upon arrival.. I also understand that if I cancel for any reason I will forfeit 25.00 of my deposit the rest of which will be returned to me. If we at Zion Security cancel the course for any reason the full deposit will be returned to you. No deposits may roll over into another course!

BASIC REQUIREMENTS:

1. I am a citizen of the United States of America and have never nor do I intend to renounce

my citizenship. (Proof of citizenship is required).

2. I agree to abide by the safety rules and procedures while on the range as required by

Zion Security Instructors. I realize that ANY violations of safety procedures or ANY acts

deemed unsafe by any of Zion Security instructors will result in my IMMEDIATE

termination from the course and shooting range and that I will forfeit all monies paid.

3. I also will agree to sign a hold harmless agree that releases McLaughlin & Sons D/B/A

as Zion Security or any other of their instructors, from any injury I may

sustain while training.

4. I have never been convicted as a felon, nor is it unlawful for me to own, possess or train

with a firearm.

STUDENT’S SIGNATURE: ____________________________ DATE: _______________

(Please print all information clearly and your name exactly as you want it to appear on your certificate)

NAME: _____________________________________________________

ADDRESS: __________________________________________________

CITY: ___________________________STATE: _________ ZIP: __________

PHONE: ___________________________ REFERRED BY: ________________

TYPE OF FIREARMS YOU WILL BRING TO THE COURSE: (MAKE, MODEL & CAL.)

PISTOL ______________SHOTGUN: ______________ RIFLE: ______________

If possible we recommend that you bring two pistols to any pistol course in the event one breaks or becomes inoperable during the shoot.

Have you had any firearms training prior to this course? ________________

If so, on the back of this form give a brief description of what type of training and where you received it.

ZION SECURITY TRAINING 1395 Co. Rd. 6310 West Plains, Mo. 65775

PHONE: 417-255-1612 FAX: 417-256-3947