Safety Violation Report

You can use this form to report a suspected safety violation at the Club. When completed, the form will email a copy to the Executive, who will then review the report and act on appropriately. To be considered valid, we require your name, email address, a voice contact number and a brief description of the alleged event or incident. Please be as descriptive as possible.

Contact information should additional follow up or clarification be required:

You agree to abide by the rule and regulations of the Burlington Rifle and Revolver Club. Please check this box to continue.

When you press send, a copy of the form will be emailed to our Executive for their review. You will also be sent a carbon copy and then you should be redirected back to the main page. If you are not redirected back to the home page, it could be a browser or javascript setting on your end. Do not keep pressing the send button. Please make sure that your email program will accept email from * Please check remember to check your SPAM folder if you do not get a copy to confirm receipt of your application. Due to server load, this can take up to 30 minutes.