Range the infraction occurred on*: —Please choose an option—Range 1Range 2Range 2BRange 3Range 4Range 5Other

Type of Infraction* (please select all that apply): Disobeying range rulesDisregarding hot/cold range statusDamaging range propertyNot cleaning upMuzzle awareness violationUnsafe handlingBelligerenceOther (please specify)

Name of person(s) involved (if known):

Member number of person(s) involved (if known):

Were any guests involved in the infraction?*: YesNoUnsure

Please, describe the situation*:

Upload any photos (3 MB max.):

I ackowledge that the information in this form is correct and accurate to the best of my knowledge and that I will be contacted by the Board of Directors for further information.*:

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