OPTIONS FOR HOMELAND DEFENSE, INC

PO Box 1237

Alpine, TX 79830

Voice: 432-837-5143: Fax 432-837-7183

e-mail: help@warriorspress.com

Web Address: http://www.warriorspress.com/optionsforhomelanddefense.htm

Name (Please Print or Type)_____________________________________________________

Address: Street, Apt # __________________________________________________________

City: ____________________________________ State: ________________ Zip: __________

e-mail address: _________________________ Day Time Phone No . _____________________

Course you wish to enroll in _______________________________________Cost: ___________

PAYMENT METHOD: Circle one: Check Money Order VISA MasterCard

Card No. ________________________________________ Exp. Date (mm/yy) _____________

I, by my signature below, hereby affirm and attest that I do not advocate the initiation of force or violence for any political purpose. (The operative word there is “initiation.” The use of force or violence for the protection of you life, liberty and property is a God given, constitutionally guaranteed right.) Also, if you are enrolling for a rifle, pistol or shotgun advanced course, you are hereby certifying that you intimately familiar with the four basic firearms safety rules and are competent in the topics covered in the respective basic courses.

Furthermore, I understand that there is a certain amount of inherent danger and risk involved in participation in any sport or event requiring vigorous physical activity or involving the use of firearms, as well as in the use of firearms in general. I understand these risks can include my injury or death, or damage to my property or equipment. Therefore, I hereby affirm by my signature below that I accept all such risks as my own, and I release, indemnify, and hold harmless the land owner, the course organizer(s), the course instructor(s), the course sponsor(s), and anyone who assists in the operation or conduct of this event. I further affirm that I have no physical condition or ailment that would cause undue risk to myself or others by my participation in this course, and that there are no laws prohibiting me from the use of or possession of any firearms or other weapons that I may use or possess during this course.

______________________________________________________

Participant/Student Signature and Date

Briefly describe your pertinent shooting experience (use the back, if necessary):

 

 

 

 

 


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Basic Defensive Pistol

Basic Defensive Carbine

Basic Defensive Shotgun

Advanced Three Gun

Force on Force Training

Women's Advanced Personal Protection

Long Range Precision Rifle

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