Defensive Pistol Registration Form Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Phone *What is the NAME of the course you wish to take: *Date of class you wish to take: *Do you have a valid Massachusetts Class A LTC? *YesNoDo you presently reside in Massachusetts? *YesNoAre you at least 21 years of age and a U.S. citizen? *YesNoAre you a member of Danvers Fish & Game Club? (You don't have to be but members receive discounted pricing) *YesNoHow often do you shoot pistols? *List any firearms courses you've taken from us or other instructors/academies. (Be specific by listing the name of the course and the name of the instructor/organization as well as the date completed if possible.) *What firearm (make, model, caliber) will you be bringing to class? (Please be sure to read the equipment requirements list [linked to in the course description] to be sure your firearm conforms.) *Please tell us the holster you'll be using (make and model). Be as specific as possible and be sure it conforms to our requirements in the equipment list. * Do you have at least three magazines for your pistol? (If not, you will need to purchase them prior to class.) *YesNoDo you have a gun belt and belt-mounted magazine pouches for at least two spare magazines? If not, you will need to purchase them prior to class (see equipment list linked to in the course description). *YesNoThis class requires physical activity, including periods of rapid movement and kneeling. Do you have any injury, handicap, or disability? *YesNoIf you answered yes to the above question, briefly describe your ailment or disability.Equipment List *I have read over the equipment requirements for this course (linked to in the course description) and agree to come to class with the required gear.Do you agree to the Paladin Group Training Class Policies? *YesNoSubmit