ASH Registration Form

Class Registration Form

If you have any questions, please contact Steve Cammack, Lead Instructor at 815-272-5000 or email at StevenCammack@Yahoo.com.
Full name: (As it appears on your state issued ID or Drivers License)

First NameMiddle NameLast NameSuffix
Date of Birth:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Full address:

Street Address

Street Address Line 2

CityState

Zip Code
Phone number:

Area CodePhone Number
E-mail:
What type of class are you registering for:
Class date:

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Do you have prior military experience?
I agree to the following statement:

The participant (named above) affirms that they are in no way disqualified from legally owning or possessing a firearm or ammunition. The participant understands that they are taking this class for instructional purposes only and they are fully responsible for their own actions and to follow the laws of jurisdictions they are in or travel to. ASH Firearms Training and its instructors are not liable for any negligence or crimes committed by the participant during class or anytime thereafter.
Should be Empty:

Class Registration Form