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ICE Firearms & Defensive Training Student Information Sheet CONFIDENTIAL
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First name
Your answer
Last name
Your answer
Name of class
Your answer
Date of class
MM
/
DD
/
YYYY
Home address
Your answer
City
Your answer
State/Region
Your answer
Postal code
Your answer
Phone number
Your answer
Email
Your answer
Date of birth
MM
/
DD
/
YYYY
NRA Member ID Number
Your answer
Are you over 18 years old?
Yes
No
Parent/Guardian name
Your answer
Parent/Guardian phone number
Your answer
Emergency contact name
Your answer
Emergency contact phone number
Your answer
How did you hear about the class?
Your answer
Reason for taking the class
Your answer
Previous shooting experience
Your answer
Is there anything specific you want to work on/what are you expecting to get from this class?
Your answer
Do you have any disabilities?
Your answer
Do you need any accommodations? (if you have disabilities)
Your answer
Do you have any health issues that we should be made aware of before you go to the range?
Your answer
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