Please Mail to:
Birds Landing Sporting Clays
2099 Collinsville Rd  Birds Landing, CA 94512
or Fax to (707) 374-2814
Mailing Address:

City:      State:     Zip: 


Home Phone:               Daytime Phone: 

NSCA Member?    ( Yes   /  No  )

NSCA #:            NSCA Class: 

NSCA Concurrent 1:         NSCA Concurrent 2: 

Flight Request (Check One):   Pre-Flight          Main Flight 
To guarantee squad, please mail forms in same envelope.
Pre-flight maximum squad size: 4 shooters            Main flight maximum squad size: 6 shooters
Main Event ($99):    $
          NSCA/CSCA Target Registration Fee ($6):    $
    Shooter Derby ($10):    $
Optional Donation :    $
Total:    $

Payment Method:
Cash:       Check: 
Visa / MC # 

Signature:_________________________________3 Digit Security Code: 

       Fill out form, print, then mail or fax to Birds Landing Sporting Clays for processing.