Dynamic DryFire Application

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Harder to Kill Training Group Dryfire Dynamics

Email *

Name *

Alias or Nickname

Address *

Phone number *

Sponsor if any

Emergency Contact Name & Phone # *

I consent to a background check ($39 Fee applies) *

Yes

Maybe

Other:

If you selected no, why?

Previous Training *

With Coach Jose

Law Enforcement (Active )

A Civilian trained by a Firearm's instructor (NRA etc)

Civilian Firearm's instructor (NRA etc)

Doctor / Nurse

Military (Active)

Military (Veteran)

Law Enforcement (Retired)

Competitive Shooter

First Responder

First AID CPR BLS

Muay Thai

HaganaH / Krav Maga

MMA / BJJ

None

Other:

Required

Can you swim? *

Yes

If Yes, What Level *

I can float

I can swim in a pool all day, but not the ocean

I can swim in the Ocean, but I stay near shore

I swim easily in the ocean and surf , snorkel and/or explore below the waves

I'm a cert. Diver

I swim w/ sharks

I own a Firearm *

Yes

I will purchase one before starting this course

My experience with firearms: *

Guns scare me.

I know they go "Boom"! That's about it.

I shot a gun, once

I shoot a few times a year at least to keep up some practice

I play Call of Duty all night

I'm John Wick and Rambo's Baby

I've trained formally w/ instructors

Military/LEO

Required

I own a Pistol... *

Yes

It's on the Way!

If Yes, What Model & Caliber?

Rate your Fitness level

I am a freakin Navy SEAL

I am an athlete and a shooter, a tactical athlete.

I Lift, I run, and/or I fight. For fun mostly.

I work out often. But no fighting for me thank you.

I work out, carefully, because I am full of injuries.

I can't remember the last time I worked out.

Oh, no why are you asking me this? !

Other:

Do you own an AR/M4 style Rifle? *

Yes

Other:

If Yes, Make & Model

Caliber?

556/223

762

300AAC

.22

Other:

Clear selection

If Other...

Shotgun Pump action

Shotgun Semi Auto

Bolt Action Rifle (w/ Optic)

Other:

I understand the minimum weapon requirement for this class is a semi-automatic pistol. ( Revolvers & Training pistols are not approved ) *

I understand

Required

I understand the minimum gear requirement for this class is an IWB (inside the waistband) holster and 1 empty magazine. *

I understand

Required

I have or will acquire before my first session *

Range Belt/ Battle belt

OWB Holster

IWB Holster

OWB Magazine Holster (2mags)

Fixed Blade Knife/ sheath holster

3 training or empty Magazines for my weapon system

Weighted vest or Tactical vest/Chestrig ( Not Required )

Small Flashlight

1 CAT Tourniquet

Handwraps & Zipties

Note Pad & Pen

Dedicated Go Bag ( Gear bag for all this equipment )

Other:

Required

Review The Four Firearm Safety Rules (must check each off) *

1. Treat every gun as if they are Always Loaded

2. Never point the firearm at anything you are not willing to destroy

3. Keep your fingers off the trigger until your sights are on the target

4. Be sure of your target and what is beyond it

Required

I have Read, I Understand and I will always Obey the Four Firearm Safety Rules *

Yes

Training Creed (must check each off): *

I will abide by all Rules and customs set by Coach Jose and the training Center

I will Always arrive on time or otherwisw notify Coach

I will Always arrive prepared w/ ALL required kit/gear

I understand being on time and prepared is part of my training

I will always practice partner preservation during training

I will NEVER bring live ammo to the training center

I will NOT share pictures or video of training or my fellow operators without approval

I will NEVER use anything I learn during training to break the law

I will always be clean and groomed for training ( NO smells, long nails, etc )

I will show Respect above all else

I AGREE TO ALL OF THE ABOVE

Required

I will NEVER bring any live ammunition into the training center, No EXCEPTIONS, NO DUMMY ROUNDS! *

I Agree.

Required

There are NO LOADED GUNS EVER at the Training Center! *

I Agree.

Required

I will NEVER bring a loaded gun into the gym. *

I Agree.

Required

I will keep my weapon system in its holster, bag and or case until I receive clearance to gear up for class. *

I Agree.

Required

I will not loiter outside of the training center while wearing any tactical gear of any kind. *

I Agree.

Required

I will not deploy brandish or otherwise display my weapon system (or any weapon of any kind) in the parking lot of the training center at anytime for any reason. *

I Agree.

Required

I will NEVER bring any live ammunition into the training center, No EXCEPTIONS, NO DUMMY ROUNDS! *

I Agree.

Required

I will not bring guest's to spectate or visit at any time without approval. *

I Agree.

Required

I understand that there is a 1 strike system in play at the training center, If I break any rule at any time I may be permanently banned from training at the center. *

I Agree.

Required

When do you plan on starting training ? *

YYYY

Anything else we should know or you would like to tell us before review your application? *

I understand that there can be up to a 72hr processing time for this application and that I will not be able to begin training until it has been completed. *

Yes

Required

Send me a copy of my responses.

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