Registration Form- October 18-19, 2003 - Oregon State 4-H ...

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Oregon 4-H Master Shooting Sports Leader Training
March 1-2, 2013
Bill Scholtes Klamath Sportsman’s Park
Keno, Oregon
&
Western Action Shooting Training
March 2-3, 2013
Bill Scholtes Klamath Sportsman’s Park
Keno, Oregon
Registration Form
Registrations accepted through 5:00 PM, February 27, 2013 for both training sessions
Complete one registration form per participant
REFUND POLICY
Fees are non-refundable February 28, 2013 or later.
Name ______________________________________ Male __ Female __ County ________________________
Address ______________________________________________ Phone ______________________________
City _________________________ State ________ Zip ____________ Email _________________________
I’m requesting: _____vegetarian meals ______ other (food allergies, etc. _____________________________)
The person named above is at least 21 years of age and is an approved 4-H Volunteer Leader in
____________________________ County. Signature of 4-H Agent (required):
4-H Master Shooting Sports Leader Training
Option 1: Full time attendance is required for one 12-hour track to complete the Oregon 4-H Master Shooting Sports
Volunteer Training Program (includes first discipline).
Option 2: Eight (8) hour discipline tracks are available Saturday for those volunteer leaders who received prior State 4-H
Shooting Sports training in the 2010/11 or 2011/12 4-H years.
Option 3: Full time attendance is required for one 12-hour track to complete the Western Action Shooting Volunteer
Training Program. Registration is only open to qualified 4-H Master Shooting Sports Leaders.
I want to be enrolled in the (pick one):
Friday and/or Saturday, March 1-2, 2013
____Archery Track,____ Muzzle Loading Track, ____Pistol Track,____ Rifle Track, ____ Shotgun Track
I want to be enrolled in the:
Saturday & Sunday, March 2-3, 2013
____ Western Heritage Shooting
SEND THIS DOCUMENT WITH THE FEE AND PAYMENT FORM

Oregon 4-H Master Shooting Sports Leader Training
March 1-2, 2013
The Oregon 4-H Youth Development Education Program recognizes and supports these shooting sports
disciplines at this time: archery, muzzleloading, pistol, rifle, shotgun, and Western Action Shooting.
The Master 4-H Shooting Sports Leader Training will provide leaders with information on:
1. Age appropriate equipment and activities
2. Risk management
3. Equipment storage requirements
4. Teaching skills for classroom and range
Firearms and materials for the workshop will be provided. Safety will be a primary concern. Please bring your
own eye and hearing protection.
Schedule- tentative:
Logistics for Master Shooting Sports Leader Training
Friday 5:30 p.m. Registration check-in for Option 1 participants
6:00 p.m. Oregon 4-H Shooting Sports
10:00 p.m. Adjourn
Saturday 8:00 a.m. Registration and check-in for Option 1 &2 participants
8:30 a.m. Discipline Training
12:00 p.m. Lunch (Provided)
1:00 p.m. Discipline Training
5:00 p.m. Practicum
6:00 p.m. Graduation
Training Location:
The evening training for disciplines (Option 1) will begin Friday, March 1 at 5:30 p.m. at the Klamath County
Extension Office, 3328 Vandenberg Road, Klamath Falls, OR 97603. Saturday discipline classes (Options 1 & 2)
will be held at the Bill Scholtes Klamath Sportsman’s Park, Keno, Oregon 97627. The park is located at 22811
Oregon 66 (Green Springs Hwy). It is about 4 miles from the small town of Keno.
http://www.sportsparkkeno.org/pages/directions.html
Lodging and Meals:
Participants are responsible for their own for lodging and meals. Meals will be provided as outlined on the
schedule above. Participants may provide their own additional snacks and/or beverages.
If you have any questions about this training opportunity please contact: Dr. David J. White, Oregon 4-H
Outdoor Education and Recreation Coordinator, 541.548-6088, david.white@oregonstate.edu
KEEP THIS DOCUMENT FOR YOUR RECORDS
SS_WAS_Klamath_2013

Western Action Shooting Training
March 2-3, 2013
The Oregon 4-H Youth Development Education Program recognizes and supports these shooting sports
project areas at this time: Archery, Muzzleloading, Pistol, Rifle, Shotgun, and Western Heritage/Western
Action Shooting
The Oregon Western Heritage and Western Action Shooting Leader Training will provide leaders with
information on:
1. Age appropriate equipment and activities
2. Risk management
3. Equipment storage requirements
4. Teaching skills for clubs and range
Firearms and materials for the workshop will be provided. Safety will be a primary concern. Please bring your
own eye and hearing protection.
Schedule- tentative:
Logistics for Western Action Shooting Training
Saturday 6:00 p.m. Registration check-in
6:30 p.m. Oregon 4-H Shooting Sports
10:00 p.m. Adjourn
Sunday 8:00 a.m. Check-in
8:30 a.m. Discipline Training
12:00 p.m. Lunch (Provided)
1:00 p.m. Discipline Training
5:00 p.m. Practicum
6:00 p.m. Graduation
Training Location:
The evening training for WAS will begin Saturday, March 2 at 6:00 p.m. at the Klamath County Extension
Office, 3328 Vandenberg Road, Klamath Falls, OR 97603. Sunday WAS classes will be held at the Bill Scholtes
Klamath Sportsman’s Park, Keno, Oregon 97627. The park is located at 22811 Oregon 66 (Green Springs Hwy).
It is about 4 miles from the small town of Keno. http://www.sportsparkkeno.org/pages/directions.html
Lodging and Meals:
Participants are responsible for their own for housing. Meals will be provided as outlined on the schedule
above. Participants may provide their own additional snacks and/or beverages.
If you have any questions about this training opportunity please contact: Dr. David J. White, Oregon 4-H
Outdoor Education and Recreation Coordinator, 541.548-6088, david.white@oregonstate.edu
KEEP THIS DOCUMENT FOR YOUR RECORDS
SS_WAS_Klamath_2013

Fee and Payment Form
Oregon 4-H Master Shooting Sports and Western Action Shooting Training Weekend
Option 1: Friday evening and Saturday $ 95.00 (a) $ _______
Option 2: Discipline training only (Saturday) $ 45.00 (b) $ _______
Option 3: Western Action Shooting (includes Western Heritage Project Book) $ 120.00 (c) $ _______
Registrations accepted through 5:00 PM, February 27, 2013
Total Registration Fees are due with this form. Please add lines (a-c) TOTAL ENCLOSED = $ _______
Fees are non-refundable February 28 or later.
Payment must accompany this registration form.
Make checks payable toOregon Outdoor Education & Recreation.
Registration deadline is 5:00 PM, February 27. Mail to: Shooting Sports Registrar, 3893 SW Airport Way,
Redmond, Oregon 97756-8697
Oregon 4-H State Shooting Sports Credit Card Form
Name (printed):_______________________________
County: _________________
Phone: __________________________
Total Amount of payment: _________
Credit card: □ VISA □ Master Card □ Discover Card □ American Express
Credit Card Number ______________________________ Expiration Date ________
Signature ______________________________________ Date _________________
Payment can be mailed to: Outdoor Education & Recreation, 3893 SW Airport Way, Redmond, OR 97756
Payment can be faxed to: Outdoor Education & Recreation, 541-548-8919
Payment can be scanned to: david.white@oregonstate.edu
SEND THE FEE AND PAYMENT FORM WITH THE REGISTRATION
Oregon State University Extension Service offers educational programs, activities, and materials--without regard to race, color, religion, sex, sexual orientation,
national origin, age, marital status, disability, and disabled veteran or Vietnam-era veteran status--as required by Title VI of the Civil Rights Act of 1964, Title IX of the
Education Amendments of 1972, and Section 504 of the Rehabilitation Act of 1973. Oregon State University Extension Service is an Equal Opportunity Employer.
SS_WAS_Klamath_2013