Please print this screen and complete information in pen. Only money orders or cashier�s checks will be accepted through the mail, made payable to Jeff Case. Send registration form and fee to C & R Training, P.O. Box 2229, Hutchinson, KS 67504.
Non-Refundable Registration Fee = $25.00. Balance of $50.00 is due the morning of the training. Cash is accepted on site. Full payment of $65 each is required when registering parties of 3 or more.
Remember to call 620-665-0105 or e-mail C & R Training to confirm seating availability. You must be 21 to participate.
PLEASE PRINT LEGIBLY!!
Training Date you wish to attend:
Last Name:
First Name:
Middle Name:
Birthdate:
KS DL or KS Non-Driver ID No.:
Address:
State:
Zip Code:
Telephone Number:
E-mail address:
Where did you hear about us?
