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Participant named wants to use FLETCHER ARMS, indoor gun range. Participant acknowledges and fully understands that Participant will be engaging in activities that involve risk of serious injury, including permanent disability and death and severe social and economic losses which may result not only from his/her own actions, inactions or negligence, but also the actions, inactions, or negligence of others, the rules pertaining to use of the gun range and or the condition of the gun range or any equipment used by Participant or by others Further, there may be other risks not known or not reasonably foreseeable at this time. Participant assumes all of the foregoing risks and accepts personal responsibility for the damages following any injury, permanent disability, or death.

 

I, Participant release, waive, and discharge any and all claims of damages for death, personal injury or property damage which I or my heirs may have, or which I or my heirs may hereafter acquire as a result of my use of the gun range or otherwise, and which may be asserted by me or on my heirs behalf against Fletcher Arms, and the agents officers, directors and other employees of Fletcher Arms, other participants and if applicable the owners of the premises in which the Gun Range is located. This release covers the negligent use, maintenance, construction and design of the Gun Range and the negligent supervision of Participants and other person's use of the Gun Range.

 

__________________________Mandatory Questions____________________

I am not a felon.

I Agree

I am not under indictment in any court for a felony or any other crime for which a judge could imprison me for more than one year.

I Agree

I am not currently under the influence of alcohol.

I Agree

I am not under the influence of or addicted to marijuana or any depressant, stimulant, narcotic drug or any controlled substance.

I Agree

I am 18 Years of Age or Older

I Agree

I have not been convicted in any court of a misdemeanor crime of domestic violence.

I Agree

I have not been adjudicated mentally defective or committed to a mental institution.

I Agree

I understand I am responsible for any damages I cause on the range or to range equipment.

I Agree

I will wear eye and ear protection at all times.

I Agree

I am not having suicidal thoughts or feelings.

I Agree

 

First Range User Name

First Name*

Last Name*

Phone*
First Range User Date of Birth*
First Range User Signature*
Second Range User Name

First Name*

Last Name*
Second Range User Date of Birth*
Third Range User Name

First Name*

Last Name*
Third Range User Date of Birth*
Fourth Range User Name

First Name*

Last Name*
Fourth Range User Date of Birth*
Fifth Range User Name

First Name*

Last Name*
Fifth Range User Date of Birth*
Sixth Range User Name

First Name*

Last Name*
Sixth Range User Date of Birth*
Seventh Range User Name

First Name*

Last Name*
Seventh Range User Date of Birth*
Eighth Range User Name

First Name*

Last Name*
Eighth Range User Date of Birth*
Ninth Range User Name

First Name*

Last Name*
Ninth Range User Date of Birth*
Tenth Range User Name

First Name*

Last Name*
Tenth Range User Date of Birth*
Parent or Guardian's Email Address

Email
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
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.


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