Thunder Ranch®, Oregon
Course Application Form

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Course Requested:___________________________Course Date______________

Tutorial Dates Requested:_____________________________________________

Name:_____________________________________________________________
(As you would like it to appear on your diploma.)

Nickname:__________________________________________________________
(For class name tag.)

Address:____________________________________________________________

City:_______________________________State:_________Zip:_______________

Phone (home):____________________________(work)______________________

Email:______________________________________________________________

Date of Birth:___________________Place of Birth___________________________

Place of Employment:_______________________Occupation__________________

Prior Firearms Training:_________________________________________________

Make, model and caliber of firearm(s) to be used in class:_____________________

_____________________________________________________________________

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Please check one and provide information requested:

___ I have enclosed evidence of no criminal history from a local law enforcement agency on official departmental letterhead.

___ I have enclosed evidence of current, active, full-time service with a public law enforcement agency, with the United States Armed Forces, or with government security agencies. Please enclose a copy of I.D. or appropriate verifiable credential.

___ A copy of a current concealed carry permit or federal firearms license.

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By signing this application, I understand and agree to the following:

1. Thunder Ranch’s® operation depends upon the careful control of deadly weapons by each student, and such control depends upon the wholehearted cooperation of its clients; therefore, I understand that my instruction may be terminated at any time during the course if the staff deems my cooperation or interpersonal behavior unsatisfactory.
2. I will abide meticulously by any and all safety procedures required at Thunder Ranch®, and I agree to sign a statement releasing Thunder Ranch®, Inc. from any and all injury I may sustain during the training program.
3. I will be at least 18 years of age at the time of class or will be accompanied by my parent or guardian, who will accept full responsibility for my actions.
4. I understand that my deposit is non-refundable and non-transferable.
   Thunder Ranch reserves the right to cancel any course or tutorial with
   120 days notice with a full deposit refund.
5. All applicable local, state and federal laws should be adhered to.

*Please Sign:_________________________________Date___________

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I have enclosed the following:

1. The completed application
2. Credential qualifications
3. $500 deposit (cash, check*, Visa/MasterCard)
   All Thunder Ranch Offsite classes are to be paid in full

Make checks payable to Thunder Ranch®, Inc. If you would like to charge your deposit, we need the following information. *Please note: There is a $25.00 fee on all returned checks.

Your name as it appears on the card____________________________

Card number_______________________________Exp____________

Signature:_________________________________Date___________

V Code: (last 3 numbers on the back of credit card) ________________