Shooting Range Waiver
Name
First Name
Last Name
Age
Date of Birth
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Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you 18 years old and above?
Yes
No
Are you pregnant?
Yes
No
Do you have a heart condition?
Yes
No
Do you smoke?
Yes
No
Are you under the influence of alcohol?
Yes
No
Are you allowed by local law or federal law to own firearms?
Yes
No
Do you have a valid or state issued ID?
Yes
No
If yes, please upload a photo of your ID
Please upload any documents or proof that you are allowed to own and handle firearms
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Emergency Contact Person Name
First Name
Last Name
Emergency Contact Person Phone Number
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Monthly Subscription
You can become a member and you'll be charged on a monthly basis.
$
25.00
One-Time
One-time registration and fee which is good for 8 hours.
$
50.00
Payment Method
Cash
Check
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Bank Payment
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Waiver / Release / Agreement
I confirm that all information in this form is accurate and true.
I confirm that I understand the risk, hazard, injury, or danger in participating in this activity.
I release this company and its employees from any liabilities, damages, accidents, injuries, or harm that might happen during my stay and participation.
I confirm that I'm lawfully allowed to own and handle a firearm.
I understand that this is a rented firearm and not allowed to bring it outside.
I confirm that I do not have depression or suicidal thoughts.
I confirm that I have not convicted of any felony or domestic violence.
I confirm that I am 18 years old and above and I can handle firearms appropriately.
Signature
Date Signed
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-
Day
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