NAVIGATION
Black Badge Course Application
Or A Refresher
Is this your first Black Badge course?
GENERAL INFORMATION
If you would like to participate in one of our IPSC Black Badge courses, please complete the Course Registration Form below and an Instructor from your area will get back to you to discuss the course requirements with you.
Please use your TAB key or your MOUSE to navigate the fields on this Registration
Form. If you accidently hit ENTER at any time, the form will be automatically sent and
you will have to begin again. When you've finished, simply use the "Submit Registration" button.
Full Name
Street
City/Town
Province
Email Address
Res. Phone
Cell Phone
Postal Code
Bus. Phone
Fax
At which club are you currently a member?
Preferred Course Location
Would you be willing to travel (up to an hour) to take this course?
Yes
No
I am at least 18 years of age
Yes
No
What, if any physical condition do you have
that might affect your performance
on this course. Please explain
Please list any other firearms courses
you have successfully completed in
the past 5 years
How long have you been shooting handguns?
Do you have an ATT (Authorization To Transport) your handgun?
Yes, I have an ATT
I do not have an ATT yet
Do you have all of the required equipment
to participate in a Black Badge Course?
Yes
No, I do not have the following items
Gun
Holster
Gun Belt
At Least Four
Mag Pouches
At Least Four
Speed Loaders
At Least four
magazines
If you'd like to add a comment or ask a question,
please enter it here
The information you provide to IPSC Ontario is kept strictly confidential. It is used only by IPSC Ontario to evaluate your suitability to participate in our IPSC Black Badge Training Program.
This page is the property of IPSC Ontario
No