Please submit 1 form for each student you are registering

 

Registration closes at noon the day before the class. 


Once the form is submitted, you will receive a confirmation message and further instructions.


By submitting this application, the student agrees to abide by any and all safety procedures required by Brothers N Arms Gun Range.  The student also agrees to sign a statement releasing Brothers N Arms, LLC and Close Quarter Combat, LLC from any responsibility or liability for any injury the student may sustain during the training program. 


Safety is the MOST important issue and instruction may be terminated at any time if the student is determined to be unsafe to themselves and/or other students and staff.​
 

If you have any questions regarding the class you have selected, please contact the instructor by phone at (601) 325-5610 or email info@cqcselfdefense.com


PLEASE REVIEW OUR CLASS RE-BOOKING AND CANCELLATION POLICY 

Register for Classes

Enter Student's Name

Enter name EXACTLY as appears

on Drivers License. Include suffixes

such as Jr., Sr., II, etc. 

Drivers License #

Enter Drivers License #

Date of Birth

Home Address

Phone Number

Email Address

Date of Course

Would you like

to rent a gun?

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Close Quarter Combat, LLC
4657 US Hwy 49

Hattiesburg, MS 39401
(601) 325 - 5610

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