Waiver Forms If you are human, leave this field blank.Page BreakClass/Event *Pistol Skills NightCarbine Skills NightDefensive PistolGunfighting 101Other Shooter InformationName *Date of Birth *Email *Address *Apt, suite, etc.CountryUnited States (US)United Kingdom (UK)CanadaAustralia---AfghanistanÅland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAmerican SamoaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelauBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraÇaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqRepublic of IrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Martin (Dutch part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaWestern SamoaYemenZambiaZimbabweCityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces (AA)Armed Forces (AE)Armed Forces (AP)American SamoaGuamNorthern Mariana IslandsPuerto RicoUS Minor Outlying IslandsUS Virgin IslandsZip codePhone *Page BreakQualifying Range Questions1. Is this your first time shooting a firearm? *yesnoIf yes, please note that you must be accompanied by an experienced shooter or you must complete a "hands-on" basic firearm safety course ($30 instructor fee).2. Are you UNDER 21 years of age? *yesnoFederal law prohibits the sale of handgun ammunition to persons under 21 years of age. Shooters under 21 years of age will not be rented handguns.3 Are you a fugitive from justice? *yesno4. Are you an unlawful user of, or addicted to, marijuana; or any depressant stimulant or narcotic drug or any other controlled substance? *yesno5. Have you been convicted in any court of a crime punishable by imprisonment for a term exceeding one year, even if you were given a shorter sentence? *yesno6. Have you been adjudicated mentally defective or committed to a mental institution? *yesno7. Do you have any promptings or intentions of doing harm to yourself or someone else today? *yesno8. Have you been convicted in any court of a misdemeanor crime of domestic violence? *yesno9. Are you subject to a court order restraining you from harassing, stalking or threatening an intimate partner or child of such partner? *yesno10. Are you prohibited from possessing a firearm in this State, or in any other State? *yesno11. Are you, or do you suspect that you are, pregnant?* *yesno*If you are pregnant, or you may be pregnant, you will not be allowed access to the range due to loud noise levels and potential lead exposure.Page BreakBy signing below, I affirm the following: I am able to lawfully possess, own and use a firearm. I have purchased my firearm(s) and equipment from a reputable dealer and manufacturer. I am competent to handle the firearm that I have brought to the Range and purchased ammunition that is in good working order and inspected it for malfunctions. I am mentally fit to handle, possess and use firearms and I am not aware of any condition that would prevent me from handling a firearm safely. I will comply with all range directions, including the Range Standards Use Agreement. I am responsible for my own acts, including but not limited to carelessness, ignorance, negligence, willful and wanton conduct, gross negligence and strict liability offenses both in tort and criminal actions. I have reviewed and understand the Range Standards Use Agreement , which is incorporated herein as a specific condition of my use of the Range. I am not aware of any medical condition that would impede my ability to handle firearms safely. If I do have a medical condition, I have obtained approval from my doctor to engage in shooting sports. I assume liability for my own acts during my use of the Range. SignatureReset SignatureSubmit
