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Total
Prize Fund
Moose Charities
**MAC
Range Fee
Rating
Moose International Skeet-Trap-Sporting Clays Shoot
Hosted by Branson, MO Lodge 2692
May 21-22, 2021
n
Ozark Shooters Sports Complex
759 US HWY 65, Walnut Shade, MO
(11 miles north of Branson)
Moose ID # (Required)
Registrant L/C # StateDaytime Phone # Email
Skeet & Trap - Friday, May 21, 2021 afternoon
Sporting Clays - Saturday, May 22, 2021 late morning
SECTION 2 —
Check P Your Event Choices
SECTION 1 — Registration
EACH PARTICIPANT MUST COMPLETE THEIR OWN REGISTRATION FORM BY APRIL 30, 2021
SECTION 5 — Mixed Trips Events SECTION 6 — Blind Draw Friday, April 17th — 6:00 PM
Trap
Sporting
Clays
All Events
*If rating unknown please enter an E* ATA/NSSF#
(Each competitor can participate in any combination of events)
New shooter Instruction Class
(please check)
First time shooters - We welcome those that have never shot before. We will conduct a class
on how to shoot safely. This will be held on Friday morning at the shooting complex.
Time to be announced.
*Important: Any omissions on this form will delay the official date of acceptance.
*All registrants must sign a liability waiver & publicity release on-site in order to participate.
For further assistance please contact Camille Ruffino at (630) 966-2213.
Send all completed entries to
Moose International, Attn: Camille Ruffino, 155 S. International Drive, Mooseheart, IL 60539-1172
Skeet
$20.00
$10.00
$5.00
$10.00
$5.00
$10.00
$5.00
$10.00
$35.00
$35.00
$60.00
$140.00
$20.00
$45.00
o
o
o
o
o
SECTION 3 — Payment Page
REFUND POLICY: Participants will be eligible to receive a full refund when cancelling prior to the registration deadline date of
Friday, April 30, 2021; after this date there will be NO REFUNDS issued, regardless of the circumstances.
Name
No.
$
Name
No.
$
Name
No.
$
Name
No.
$
Notes
Date Received by Finance / / Received by
Date Received by Activities / / Received by
Payment Information
Card Type (please circle) Visa Master Card Discover American Express
Name as it appears on Card:
Credit Card Number:
oooo oooo oooo oooo
Amount $
Expiration Date:
oo/oo
CVV Code:
ooo
American Express CVV2 Code:
oooo
Signature
:
*Check, money order or credit card information must accompany all entries and must be postmarked by April 30, 2021. *All checks and money orders should be made payable to Moose International and must be earmarked 2021 Skeet, Trap, Shooting Clays Tournament. *Returned checks must be replaced with an alternate form of payment within 10 days or entry will be cancelled.
For Office Use Only (US Funds Only)
*To complete the application process email addresses and/or phone numbers for EACH participant is required.
Any omissions will delay the official date of acceptance. Tournament information will be communicated via email only.
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Moose International Skeet-Trap-Sporting Clays Shoot
Hosted by Branson, MO Lodge 2692
May 21-22, 2021
n
Ozark Shooters Sports Complex
759 US HWY 65, Walnut Shade, MO
(11 miles north of Branson)
Ist
A
nnual
Moose International Skeet-Trap-Sporting Clays Shoot
Hosted by Branson, MO Lodge 2692
May 21-22, 2021
n
Ozark Shooters Sports Complex
759 US HWY 65, Walnut Shade, MO
SECTION 3 — Shooting Sports Waiver and Consent
Host Lodge: Branson, MO Lodge 2692 (Hospitality room at host hotel)
Event Location:
Ozark Shooters Sports Complex
759 US HWY 65, Walnut Shade, MO 65771
(11 miles north of Branson)
Moose International registration contact:
Camille Ruffino (630) 966-2213 cruffino@mooseintl.org
On-Site Lodge Contact during Tournament:
Arlen Lipper (417) 365-9548)
SECTION 4 — Hosting Lodge Information GENERAL INFORMATION
SECTION 5 — HOTEL ACCOMMODATIONS
Clarion
2820 W. 76th Country Blvd.
Branson, MO 65615
For reservations (800) 725-2236 Press 0
Reservation deadline April 30, 2021
Rate $89.00 + tax for single and double Rate three to a room $94.00 + tax Rate four to a room $99.00 + tax
Includes complimentary deluxe hot breakfast featuring bacon, sausage, scrambled eggs, breakfast potatoes, biscuits, gravy, fresh fruit and 24 hour coffee and juice bar for our guests.
The hotel offers a large outdoor pool and hot tub as well as an indoor pool, hot tub, sauna and exercise room.
BE SURE TO BOOK YOUR ROOM!
Moose International Host Hotel
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Moose International Skeet-Trap-Sporting Clays Shoot
Hosted by Branson, MO Lodge 2692
May 21-22, 2021
n
Ozark Shooters Sports Complex
1. Eligibility: Only Loyal Order of Moose and Women of the Moose members holding an active membership at the time of the tournament will be eligible to play and compete for tournament prizes. All players must present a valid photo I.D. and a valid Moose membership card.
2. Good sportsmanship will be the prevailing attitude throughout the tournament. Tournament Director and/or
Moose International may recommend disqualification of a player for unsportsmanlike conduct or tactics detrimental to the tournament.
3. Gambling on the tournament is not permitted and will result in disqualification and forfeiture of prize money.
4. No entry forms will be accepted unless all information is entered and entry fees are paid in full, by
the established registration deadline.
5. Payment: All remittances must be in the form of a check, money order or credit card in U.S. funds. Checks
and/or money orders should be made payable to Moose International and earmarked with the current year ` and name of tournament.
6. Refund Policy: Participants will be eligible to receive a full refund when cancelling prior to the registration
deadline date. After this date, no refunds will be issued, regardless of the circumstances. No entry fees will be refunded if it is found that some teams or individuals have failed to comply with all the rules and regulations governing this tournament. This policy will be strictly enforced in all Moose International tournaments.
7. Substitute Policy: In cases of death, injury, sickness, or other emergency, Moose International may approve a
substitute’s participation. All substitutes must present a valid photo I.D. and a Moose membership card. Moose International will not be involved in the exchange of any monies between the involved parties either relating to registration fees or prize money awarded. Moose International retains the right to authorize and/or decline, any substitute’s participation. Substitutes will be authorized to participate without pre-registration as many times as needed for unexpected absences of pre-registered participants.
8. Lodge Dress Code: All participants must adhere to the hosting lodge’s dress code, and are subject to
disqualification if they do not conform to the code when violations are addressed on site. SECTION 6 — GENERAL RULES (All Moose International Sports Tournaments)
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Moose International Skeet-Trap-Sporting Clays Shoot
Hosted by Branson, MO Lodge 2692
May 21-22, 2021
n
Ozark Shooters Sports Complex
759 US HWY 65, Walnut Shade, MO
SECTION 7
1. As with all Moose International tournaments, you must be a current member of the fraternity to participate and to register for this event.
2. All house rules at the shooting complex must be followed with no exceptions.
3. We do welcome those that have never shot before as we will have members that will have a class on safety and instruction on how to shoot safely. This will be on Friday moring at the shooting complex.
4. Registration is mail in only and the deadline is April 30, 2021.
5. There will be no alcohol consumed before or during this event. If this item is not followed you will be asked to leave with not refund given and will be turned over to the General Governor.
6. You do not have to be a member of ATA or NSSF at this particular event as it will not be a sanctioned event this year.
7. Shotguns and Gauge permissible for this event: Pump, Side by Side or Over/Under, Auto. Pump and Auto must be plugged for 3 rounds max. Gauges – 12, 20, 28 and 410. Shot no larger than 7 ½. (there are a small number of rental guns available day of shoot only).
8. Shells may be purchased on site or factory loads only may be used. No reloads are authorized to be used for these events.
9. The number of clays for each event are as follows – Skeet 50, Trap 50 and Sporting Clays 100.
10. Squads will be drawn up by random draw.
11. There will be no team event. This will be an individual event.
12. When filling registration out you will be asked for you rating. If you have been shooting competitively you should
know your rating. If you have never shot before you will also be able to have a rating as well that down as well. Even though this year is not a sanctioned event we have been asked to have the participants put down their ATA or NSSF membership numbers. This will help us in the future to make this event sanctioned.
13. The shooting complex does not have information on how we will be running this shoot. For any other questions
and to keep the correct information please contact me at Moose International gdailey@mooseintl.org
