Shooting Sports Range Reservation Form
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1
2Longs Peak Council
Boy Scouts of America
Shooting Sports Range Reservation
Scout Unit _________________________________
City & ST __________________________
Begin Date _______________________________
End Date ________________________
Damage Fees
Item Rental
Trash Hauled
Check All
Item
Rental Fee
Damage Fee
Range Damage
(There is a $50 fee if
that Apply
Fee
you do not haul trash
(fee will be assessed
and clean up litter)
at time of Check out)
Office Use Only!
Office Use Only!
$30 per
BDSR Rifle Range 1
weekend
$30 per
BDSR Rifle Range 2
weekend
$30 per
BDSR Shotgun Range
weekend
BDSR Archery Range
$30 per
(Camp Jeffrey)
weekend
BDSR Archery Range
$30 per
(Soaring Eagle)
weekend
$30 per
CLP Rifle Range
weekend
$30 per
CLP Archery Range
weekend
Total Fees at reservation (Rental Fee)
Total Fees due at Check Out (Damage Fee)
Camp Ranger Signature upon Checkout______________________________________________________
Make checks payable to the Longs Peak Council, BSA
Person Reserving: _______________________________________________________________________
Address: _______________________________________________________________________________
City: _____________________________________ ST: ___________ Zip: ___________________________
Phone (H): ________________________(B) ________________________(C) ________________________
E-Mail: _________________________________________________________________________________
Unit Leader: _____________________________________________________________________________
Phone (H): ________________________(B) ________________________(C) ________________________
_______________________________________
Date: ________________
Adult First Aid Training*: Name
_______________________________________
Date: ________________
Adult LPC Range Officer Training*: Name
_______________________________________
Date: ________________
Adult NRA Range Safety Officer Training*: Name
_______________________________________
Date: ________________
Adult NRA Instructor Training Training*: Name
____________________________________________
Rifle/Shotgun/Pisol/Muzzleloader
_______________________________________
Date: ________________
Adult NRA Instructor Training Training*: Name
Rifle/Shotgun/Pisol/Muzzleloader ____________________________________________
Date: ________________
Adult NRA Instructor Training Training*: Name_______________________________________
Rifle/Shotgun/Pisol/Muzzleloader ____________________________________________
Date: ________________
Adult NRA Instructor Training Training*: Name_______________________________________
Rifle/Shotgun/Pisol/Muzzleloader ____________________________________________
Date: ________________
Adult NRA Instructor Training Training*: Name_______________________________________
Rifle/Shotgun/Pisol/Muzzleloader ____________________________________________
Date: ________________
Adult NAA Instructor Training Training*: Name_______________________________________
Date: ________________
Adult NAA Instructor Training Training*: Name_______________________________________
*If the Council does not have copies of these certificates on file, the Range Rental will not be approved.
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