16090 OAKLAND ROAD

HENDERSON, MD 21640

100 NSCA REGISTERED TARGETS

$70 ADULT ENTRY FEE INCLUDES ALL TARGET
FEES & $20 RETURNED TO CLASS MASTER THRU E
- 1st, 2nd & 3rd (50% 30% 20%, TIES SPLIT)
CONCURRENT ENTRY - $50.00
PLACES IN CLASS DECIDED BY STATION SCORES
OPTIONS AVAILABLE HOA & HOA IN CLASS - 100% BACK
TO 1 WINNER, TIES SPLIT. LEWIS CLASS - 100% BACK,
NUMBER OF CLASSES DECIDED BY NUMBER OF
SHOOTERS, 3 DEEP.
SHOOT BEGINS AT 9:00 - EUROPEAN START
ALL ENTRANTS MUST BE REGISTERED AND ON
THE COURSE BY 1:00 PM
NON-NSCA PRACTICE SHOOTERS WELCOME
TO PRE-REGISTER PLEASE CALL
410-758-1824 OR 410-778-1895 MON. -FRI.
BETWEEN THE HOURS OF
9:00 AM TIL 4:00 PM
SCHRADER’S LLC RESERVES THE RIGHT TO CHANGE THIS
PROGRAM WITHOUT PRIOR NOTICE!
 Schrader’s Bridgetown Manor
Hunting & Sporting Clays #
Registration Form
2010 WILD GOOSE SHOOT
Name:___________________________________________________
Address:_________________________________________________
City: __________________ State: _______ Zip: _________________
Phone #____________________ E-mail _______________________
NSCA#: _______________________ Current Class: _____________
Concurrent: Please Circle
Sub-Junior, Junior, Veteran, Super-Veteran, Senior Super-Veteran, Ladies

FOR OFFICE USE FILL IN FOR DEPOSIT

Entry Fee: $70.00 $________ $45.00 Deposit Required Per Entry
Includes target fees and $20.00 returned
to class, 50% 30%,20%, ties divide. Total Amount Enclosed $___________

Concurrent Entry $50.00 $________ Payment: Check Cash Credit Card

NSCA Cash Options: (Ties Divide) Credit Card - Visa or Mastercard

HOA (1 Place) $20.00 $________
High Gun In Class Card # ______-______-______-______
(1 Place Per Class) $20.00 $________
Cash Lewis $20.00 $________ Expiration Date ____/____
Shell Game $ 7.00 $________
Name as it appears on credit card:
Cart ($20.00 per cart) $________ _________________________________
5-Stand/Wobble $10.00 $________
Expiration Date: ___________________

Total Amt. of Charge $ ______________

Total Entry Fees: $________ Signature: ________________________

Less Deposit: - ________