/ 7thAnnualWisconsinState IDPA Championship
8 Stages - 130+ Rounds - Chrono - Lunch - Awards - Prizes
August 4th 2007* at Schultz Rod & Gun Club Muskego, Wisconsin

Please Write Legibly
Last Name / First Name
IDPA #
Must be a current IDPA member at match date /  Day
Telephone # ( ) -  Evening
Address
City / State / Zip
E-Mail /

Shirt Size  S  M  L  XL  2XL  3XL

Division (Check only one)
 Stock Service Pistol
 Enhanced Service Pistol
 Custom Defensive Pistol
 Stock Service Revolver
 Enhanced Service Revolver
You must be classified in your division within the last year of the match date to shoot the match (except Master) / Classification (Check only one)
 Master
 Expert
 Sharpshooter
 Marksman
Last Classification Date in this Div./Class
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Handgun
Make: ______
Model: ______
Caliber: ______ / Sub-division
 Lady
 Law Enforcement
 Senior (age 50 and up)
 Junior (age 12-20. Must be accompanied by parent/guardian for the entire match if under 18.)
Preferred Shooting time: AM (7:00 A.M. Registration)  PM (12:00 Noon Registration)
This will be a 2 flight match – ½ shooters shoot in the morning ½ in the afternoon. Please select your preference. We will be limited to 50 shooters in each flight, so sign up early to get your preference.
Make checks or money order payable to: Wisconsin IDPA
Mail Payment and Entry Form to:

Julie Williams

P.O. Box 168

Elm Grove, WI53122

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Match Fee (includes lunch)

Late Fee $20.00(after 7/15)
Match T-Shirt ($15.00)
SO Discount $20/$40 see SO AppTotal Enclosed /

$80.00

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*Rain Date August 5. Write squad requests on the back of this form. Limit 6 per squad.

More match information will be available at under IDPA

Schultz Resort Rod & Gun Club

Participation Release & Agreement

In consideration of permission to participate in the shooting contest held at Schultz Rod & Gun Club on the dates listed below, I, (print your name) ______

do hereby release the Schultz Rod & Gun Club and their directors, agents, members, tournament officials, officers, employees and servants, and any other contributor, sponsor, or affiliate from all liability which might arise from any loss, damage, injuries or death which I may sustain, and any theft, unexplained disappearance, or damage which may befall any of my property while enroute to, during and enroute from the tournament. I further assume all responsibility for any guest that I may bring. I acknowledge that I am over the age of 18 and that I have previously participated in competitive shooting events and that I am aware of the risks and hazards inherent upon such events, including but not limited to accidental discharge of firearms and loss of property through misplacement or theft. I voluntarily assume all such risks. I acknowledge that I have read and understood the rules of this event, and I acknowledge the right of tournament sponsors to terminate my participation immediately upon any failure of mine or my guests to comply with all rules, regulations, and directions of the tournament officials. I further state that I have read the foregoing participation agreement and release and freely enter into it on behalf of myself and my distributees, heirs, next of kin, executors and administrators. By accepting this invitation to compete, I am authorizing Schultz Rod & Gun Club to use any photographs taken of me during this event in its promotional literature and advertising. I understand that this authorization does not extend to any other organization or business.

I have read and agree to comply with the terms of the participation release and Agreement.

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Competitor Signature

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Parent or Guardian if under 18

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Date

Event: WisconsinState IDPA Match

Date(s): August 3rd -5th, 2007