Private Training Registration – Tap Rack Bang Training
Complete every section and share as much detail as possible so your instructor can prepare your first session.
Release & Waiver
Release, Waiver, Indemnification, Hold Harmless, and Assumption of Risk Agreement
*
Acknowledgment
*
I have read and agree to the course requirements, liability waiver, and media release above.
Your Information
Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Driver's License
*
Upload a File
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Choose a file
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Signature
*
Printed Name
*
Date of Signing
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Training Assessment
What weapons platform do you want to focus on?
*
Pistol
Semi-automatic Rifle
Shotgun
Hybrid (Primary + Pistol)
How would you rate your knowledge of safe firearm manipulation and use?
*
Complete beginner
Somewhat familiar
Comfortable and confident
Do you have a holster for your pistol?
Yes
No
N/A
What sights are on your pistol?
Please Select
Optic
Iron Sights
Iron + Optic
N/A
How many spare mags for your pistol?
None
1
2
3+
How many spare mag holsters for your pistol?
0
1
2+
Do you have a sling for your rifle/shotgun?
Yes
No
N/A
What sights are on your rifle/shotgun?
Please Select
Red Dot
Holographic
Magnified Optic
Iron Sights
Optic + Iron
How many spare mags for your rifle?
None
1
2
3+
How many spare mag holsters for your rifle?
0
1
2+
Tell us a little about yourself
Submit
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