Everyone who wishes to shoot at The Range, whether using his/her own firearms(s), or a rental firearm, must COMPLETELY fill out this form. All information supplied will be kept strictly confidential, not distributed or made available to others for any purpose, and is for the sole use by this facility to properly identify the user and document their previous experience with firearms, if applicable, and to best ensure the safety of all range users.

Use of unauthorized ammunition can result in serious injury and/or death to yourself and others. Furthermore, unauthorized ammunition permanently damages the bullet traps. DO NOT take or try to shoot any steel core or steel jacketed, tracer, armor-piercing, or any other incendiary type ammunition onto the range.

I UNDERSTAND THAT THE USE OF FIREARMS ON THE RANGE IS AN EXTREMELY HAZARDOUS AND DANGEROUS ACTIVITY THAT POSES THE RISK OF SERIOUS BODILY INJURY AND/OR DEATH. BY SIGNING THIS WAIVER, I ACKNOWLEDGE THAT I UNDERSTAND THAT THE RISK OF USING A HANDGUN ON THE RANGE IS SUBSTANTIAL AND THAT I AM RESPONSIBLE FOR MY ACTIONS WHILE USING THIS FACILITY.YOU ARE FINANCIALLY RESPONSIBLE FOR ANY DAMAGE DONE TO THE BULLET TRAPS OR ANY OTHER PART OF OUR FACILITY.

I, My agents, Assigns, Executors, or Administrators, for the consideration of being allowed to enter, rent, and use the facilities and/or firearms at THE RANGE PISTOL CLUB, INC. do absolutely assume ALL risks, and hold THE RANGE PISTOL CLUB, INC. and its Agents, Instructors, and Employees harmless from liability; whether claimed by myself or another arising out of any injury, loss or disability connected with the above use of facilities and malfunctioning firearm by another, ricochet of a bullet or other material, the intentional or unintentional weapon firing by myself or another shooter. I have completely read, understand and agree to the terms of the above waiver of liability and assumption of risk. THIS WAIVER IS VALID INDEFINITELY UNLESS EXPRESSIVELY REVOKED IN WRITING.

RAPID FIRE IS NOT ALLOWED,I UNDERSTAND THAT I WILL BE CHARGED FOR DAMAGED TARGET HANGER OR MECHANISM.

Participant / Parent / Guardian Information

Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.

By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.

Background Information

Thoroughly read each statement.

I HAVE NEVER BEEN CONVICTED OF A FELONY OR VIOLENT MISDEMEANOR.

I HAVE NOT EVER BEEN ADJUDICATED AS MENTALLY DEFECTIVE, BEEN COMMITTED TO A MENTAL INSTITUTION, OR HAVE A HISTORY OF MENTAL ILLNESS.

I AM NOT AN UNLAWFUL USER OR ADDICTED TO MARIJUANA, ANY STIMULANTS.

ANY DEPRESSANTS, ANY OTHER NARCOTICS, OR CONTROLLED SUBSTANCES.

I AM NOT DEPRESSED, SUICIDAL, OR SUFFER FROM EMOTIONAL PROBLEMS.

I AM NOT PREGNANT OR NURSING (IF APPLICABLE).

Minor's Information (Only if applicable)

Electronic Signature Consent

By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.