REGISTRATION FORM
Class /Date: (BP/Ohio CCW or PPOH) _________________
Name:_____________________________________________
(As it appears on your drivers license so that Certificate will match)
Address: ___________________________________________
City: _________________ State: ____ Zip ________
Phone Number: Home: _______________ Work _______________
e-mail: ______________________ (Please provide if available)
NRA Member? (Not required)_____________
Will you be bringing your own Firearm*? _________________
For PPOH only:
Do you hold a valid CHL? _________________
Date required course taken and instructors name:__________________________
STUDENTS ARE REQUIRED TO SIGN A LIABILITY WAIVER.
I certify the following is true. I am not a fugitive from justice, and I am not under indictment nor have I been convicted of a felony or offense involving illegal possession, use or trafficking in any drug of abuse. I am not drug dependent; I am not a chronic alcoholic; and I am not under adjudication of mental incompetence, nor have I been convicted of domestic violence.
Signature: ____________________________________________________
Make check or money order payable ($100* BP Ohio CCW / $150 PPOH Advanced CCW) to Rick Kaleda and mail to:
Rick Kaleda 2040 S. SchenleyYoungstown, Ohio 44511
*Non refundable less that 1 week prior to scheduled class date.
We have a limited number of revolvers and semi automatics for student use (Basic Pistol course only). Please let us know if you will require the use of one of our firearms. Students are responsible for purchasing ammunition for use in our pistols. Please call for details. Ammunition for use in our pistols must be pre approved and inspected before use.
For any additional questions please call (330)270-9416 Between the hours of 10:30am and 7:00pm
Course Rules and Safety guidelines:
IMPORTANT: SAFETY is our FIRST PRIORITY. Any act of unsafe behavior will result in dismissal from class without a refund. Below are some simple guidelines that will be strictly enforced.
NRA Basic Pistol Ohio CCW:
No ammunition will be allowed in the classroom. ALL firearms MUST be inspected before entry in the classroom / range portion of the class. The range portion of the class will be held the second day of class.
You should bring NO AMMUNITION the first day of class. We will not be using pistols the first day of class, but you may bring them if you have any specific questions regarding your personal firearm.
NRA Personal Protection Outside the Home:
Students MUST have completed the NRA basic pistol course required to obtain a Concealed Handgun License. Students SHOULD have obtained and hold a license. Students having completed the training but not obtained a license will be considered on a case by case basis.
If you have any questions you would like to have addressed specific to your personal firearm, LET US KNOW. We will be glad to answer your questions.
There are no nearby food services to Youngstown Rifle and Pistol. You may want to consider bringing a lunch, as we will be holding class all day. There is a pop machine but it is recommended that you bring beverages with you.
