Student Registration Form

Basic PistolShotgunRifleFirst Pistol OrientationConcealed CarryPsy. Of Gun OwnershipDefensive PistolByrna BasicsLess LethalTaserJudgement ShootingU.S. Const. 101Other

If Other, please specify the course

Dates of Class - From (MM/DD/YYYY)*

Date

Dates of Class - To (MM/DD/YYYY)*

Date

Student Registration Number (NRA Member #)

NRA#

Full Name*

First NameLast Name

Today's Date*

Date

Address*

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

City, County, & State*

Zip Code*

Email Address*

example@example.com

Date of Birth*

Date

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Driver License or State ID#*

State of Issue for Driver License/ID*

YesNo

If yes, please specify your disability accommodations

Release and Waiver of Liability
The undersigned acknowledges that the possession and/or use of firearms is inherently hazardous and carries the risk of serious personal injury, death, psychological trauma, and/or other personal or financial liabilities. By signing below, you voluntarily assume all associated risks and expressly waive any and all claims against LPS Firetac Defense Training Group & Consulting, its officers, agents, employees, and affiliates for any personal injury, death, psychological trauma, and/or any other personal or financial loss that may arise from the possession or use of firearms.

Participant Signature – Release and Waiver*

Participant Name (Printed) – Release and Waiver*

Date – Release and Waiver*

Date

State Criminal Justice Agency of

Discounted Total Rate – PKG 1

Discounted Total Rate – PKG 2

Discounted Total Rate – PKG 3

Print Name – Final Agreement Acknowledgment*

Signature – Final Agreement Acknowledgment*

Date – Final Agreement Acknowledgment*

Date

Balance Due

LPS Firetac Attendance & Lateness Policy
To maintain safety, fairness, and class quality, all students agree to the following terms upon registration:
Lateness Policy: Students arriving more than 15 minutes late may be denied entry and required to reschedule. A $35 Late Arrival Fee will apply if training is already in progress and accommodations are made.
No-Show Policy: Failure to attend your scheduled class without any prior notice is considered a No-Show. A $100 No-Show Fee will be charged, and no refunds will be issued. Re-enrollment will require a new deposit or full payment depending on course type.
Rescheduling & Cancellation: Students must provide at least 48 hours’ notice to reschedule a course. One reschedule is permitted without penalty. A second change incurs a $25 rebooking fee. Emergencies will be reviewed on a case-by-case basis with proper documentation.

By enrolling in any LPS FireTac training course, you acknowledge and agree to this attendance policy.