Centershot Registration Winter 2021 - Experienced Shooter
Event Timing: January 9 - February 13
Event Address: Riverview Church 13968 CHILLICOTHE ROAD
NOVELTY, OH 44072       (By participating you consent to allow Riverview Church to use your child’s photo for promotional reasons)
Time: 3 class times to choose from: 9am-10am, 10:15-11:15, & 11:30-12:30
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Participant's Name (First and Last) *
Date of Birth (if under 18) *
Male/Female
Street Address, City, State, Zip Code *
Phone Number *
Email *
Are you planning on bringing your own equipment? *
Required
Do you have a Matthew's Genesis bow?
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Eye Dominance *
When did you last attend a Centershot program? *
Do you attend a local church? If so, where?
Parent or Guardian's Name *
Relationship to Participant *
Parent or Guardian's Phone Number *
Secondary Emergency Contact's Name *
Secondary Emergency Contact's Relationship to Participant *
Secondary Emergency Contact's Phone Number *
Are there any dietary limitations, allergies, current medications or current medical conditions you would like us to know about? *
Required
If yes, please explain.
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