Info

 Alias:     Name: 
 SASS Badge #:    Email: 

Class (check one)

 

 Traditional

 Gunfighter

 Duelist

 Classic Cowboy

 Black Powder

 

 (reserved)

 

 Lady

 

 (reserved)

 Junior

 Other (No prizes)

Print this form and bring it with you.      

Participation Release and Agreement  (signature is required)

I do hereby release the Pelham Fish and Game 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 eighteen (18) and that I have previously participated in competitive shooting matches, 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 or property through misplacement or theft.  I voluntarily assume all such risks.  
I acknowledge that I have read and understand the SASS rules of Cowboy Action Shooting, and I acknowledge the right of tournament officials to terminate my participation immediately upon any failure of mine or of my guests to comply with all the 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 heirs, next of kin, executors, and administrators.

Signature: _____________________      Parent/Guardian (if under 18) __________________      Date: _________

Score

Stage

 Time

Misses

Procedurals

Bonus

Final Score

1   +      x5 = +      x10 = +      x___ =  
2   +      x5 = +      x10 = +      x___ =  
3   +      x5 = +      x10 = +      x___ =  
4   +      x5 = +      x10 = +      x___ =  
5   +      x5 = +      x10 = +      x___ =  
6   +      x5 = +      x10 = +      x___ =  
7   +      x5 = +      x10 = +      x___ =  
8   +      x5 = +      x10 = +      x___ =  
9   +      x5 = +      x10 = +      x___ =  
10   +      x5 = +      x10 = +      x___ =  
Official Use Only Paid: $15    $10    $5        Cash   Check                  Worker: Yes                 rev 3.06