MISSISSIPPI FANDANGO 2005 (Oct. 7-9) - PRE REGISTRATION

(please return with check  If signing up more than one shooter, please copy this sheet.)

Shooter

Real Name__________________________________________________________________________

 

Alias________________________________________________   SASS #_______________________ 

                                                                                                     (SASS Number must be filled in)

 

Address_____________________________________________________________________________

 

City______________________________________ State_____________ Zip_____________________

 

Phone Number____________________________________ 

 

E-Mail Address___________________________________ 

 

  

Attending Banquet?    Yes  No     number attending banquet  ______ (counting shooter)

 

Number of extra Saturday Lunches required ________ (NOT counting shooter Lunch)

 

Number of extra Sunday Lunches required ________ (NOT counting shooter Lunch)

 

Are you bringing a Camper?   Yes    No   Type & Size__________________________

Would you be willing to help work at the shoot?     Yes    No

Do you want to shoot as a group?     Yes    No     Please list posse on back.  We’ll TRY.

 

FEE TOTALS:

 

Please Note All Fees paid with Dollar Amounts:

 

One Shooter $55.00                           ___________

 

Junior Shooter $30.00                        ___________

(accompanied by adult)

 

Extra Saturday Lunches $5.00          ___________

(Do not count shooter)

 

Extra Sunday Lunches $5.00             ___________

(Do not count shooter)

 

Banquet Tickets $20.00                     ___________

(Count shooter)

(two banquet tickets $38.00)

                        TOTAL PAID                        ___________

 

Please send your filled out pre-registration, (this entire page) ALL fees & banquet payment by September 30, 2005 to:

Western Wisconsin Wild Bunch,

1902 So. 23rd St., LaCrosse, WI 54601

Checks payable to: Western Wisconsin Wild Bunch

**Shooting fees are not refundable after September 30, 2005.  Meals are non-refundable.  We may have to levy a handling charge for refunds.

 

 

 

 

Class (check one) 

____Trad.   (2 hand, fixed sight)

____49er  (2 hand, fixed sight)

____Modern  (2 hand, adj. sight)

____Duelist  (1 hand, fixed sight)

____Ladies (traditional)

____Ladies 49ER (traditional)

____Ladies Senior (60 & older)

____Ladies (modern)

____Senior (60 & older)

____Elder Statesman (60 & older)

____Ladies Senior (60 & older)

____Junior (16 & under)

____Frontier Cartridge BP

____BlackPowder Cap and Ball

____Gunfighter  (2 hand duelist)

____Classic Cowboy

 

OTHER_____________________________

Note- Each Class requires five shooters