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Smokin’ Barrel Guns Inc.

RELEASE, WAIVER, INDEMNIFICATION, HOLD HARMLESS, AND ASSUMPTION OF THE RISK AGREEMENT

WHEREAS, in consideration of the use of premises, and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Undersigned agrees to the following:

The Undersigned acknowledges that all firearms in their possession being transported to and from the premises must be unloaded and kept in a locked container. 

The Undersigned thereby acknowledges and agrees to have voluntarily applied to use the shooting range and Facilities operated by Smokin’ Barrel Guns Inc. It is understood and acknowledged that the use of a shooting range in which others, as well as the Undersigned, are engaged in shooting activities inherent extreme hazards, dangers, and risks. The Undersigned represents that he/she is fully competent to participate in training and shooting activities and that he/she freely, knowingly, and voluntarily assumes the risks of participating in such activities, including the risks of property damage, bodily harm, and death. 

The Undersigned acknowledges, understands, and will follow the posted and printed Range Safety Rules. The Undersigned further acknowledges and fully understands that failure to follow the posted and printed rules will result in immediate expulsion from the range. 

The Undersigned affirms that he/she has refrained from being under the influence of alcoholic beverages or drugs while on property owned and/or controlled by Smokin’ Barrel Guns Inc. Further, the Undersigned affirms that he/she understands the consumption of drugs or alcoholic beverages is expressly prohibited on Smokin’ Barrel Guns Inc. property, and that any person(s) who, strictly by our observations, appear to be under the influence of alcohol or illicit drug or emotionally unstable, shall be denied access to any part of the Facility.

The Undersigned acknowledges that he/she can legally possess or rent a firearm and that he/she has no criminal or mental background that restrict the Undersigned from such possession under penalty of law and perjury. 

The Undersigned acknowledges that certain ammunition is restricted on this range and that he/she may not use armor piercing, incendiary, or tracer, and that if such is used, any damages resulting from such use may be billed directly to the Undersigned. 

In addition, the Undersigned does for himself/herself, and on behalf of his/her heirs, executors, administrators, partners, agents, brokers, insurers, and assigns, hereby release, acquit, indemnify, and hold harmless Smokin’ Barrel Guns Inc., and its officers, directors, owners, partners, agents, brokers, employees, insurers, assigns, and all other related person, entities, affiliates, predecessors, and successors, from any and all claims, actions in law or equity causes of actions, demands, rights, damages, costs, loss of services, expenses, and compensation whatsoever arising from any damage to property, injury to person, or death, (whether predicated upon negligence or otherwise) in connection with the use of Smokin’ Barrel Guns facilities or participation in any activities therein. 

I have no intentions to harm myself or others. I agree to not use facility or equipment to harm myself, others, or property not designed and intended for target shooting. Any violation of this provision by me is a material breach of this agreement and I agree to pay Smokin’ Barrel Guns Inc., and it’s patrons for any and all damage incurred as a result of the violation, including but not limited to property loss and damage, medical bills, psychological counseling, pain and suffering, and loss of business. The Undersigned further, takes full legal and financial responsibility for any damage or harm to themselves, other individuals, rental equipment or other range equipment that is a result of the actions of the Undersigned, and received party, and/or any other individual on the premises.

Date: April 18, 2021

Range Safety Rules

1. Everyone who is using the range, regardless of experience, must first go through the range safety orientation and complete all required paperwork. No exceptions.

2. The use of alcohol and drugs before or during shooting is prohibited. Anyone suspected of being under the influence of any form of drug or alcohol will not be admitted to the facility.

3. No food, drink, chewing gum or tobacco products are allowed on the range.

4. Eye and ear protection MUST be put on before entering the range and must remain on during the entire use of the range.

5. All firearms must be unloaded, cased and locked while going to and from the range. For safety reasons loaded firearms are prohibited in all other areas of the facility. These areas include all classrooms, showroom, as well as the simulator room.

6. Shooters must remain behind the firing line at all times during open shooting hours.

7. Firearms and ammunition used on the range may be subject to inspection at any time.

8. Firearms may be un-cased or un-holstered within the confines of the shooting booth ONLY. All firearm handling is restricted to the confines of the shooting booth. Never handle firearms outside the shooting booth area.

9. Always keep firearms pointed in a safe direction while on the range. This means downrange.

10. Always keep your finger off the trigger until your firearm is pointed at the target and you are ready to shoot.

11. All targets must be placed at eye level to ensure the rounds go directly into the backstop. Be mindful of range damage, bullets do continue on a path beyond the paper and cardboard targets you are shooting at.

12. Only aimed fire is allowed on the range. This means firearms must be sighted at eye level. Shooting from the hip is specifically prohibited.

13. Firearms may only be tabled unloaded with the actions open and muzzle pointed downrange. For revolvers this means cylinder open and visible, muzzle pointing downrange. For semi-automatics this means slide locked to the rear, magazine removed, ejection port facing up and muzzle pointing downrange. The only exception is during a cease-fire.

14. If you have brought more than one firearm, use only one at a time. When finished with one, lock the cleared firearm and ammunition in the case before moving on to use the next one.

15. Drawing from concealment, a holster, or rapid fire requires approval from the Range Master, Assistant Range Master or RSO. It may be a pre-requisite to take one of the classes given at Smokin’ Barrel Guns to perform these advanced shooting positions.

16. Only use the correct ammunition designated for your firearm. Armor piercing/steel core and tracer ammunition is specifically prohibited. Smokin’ Barrel Guns staff understands the difference between steel jacketed and steel core. As a user of our facility you are expected to have the same understanding.

17. Shot guns may be used with slugs.

18. Full automatics, while not allowed without restrictions during normal open shooting hours, may be used during scheduled or arranged times with staff supervision.

19. The following procedures must be followed for any firearm or ammunition problems that occur and cannot be resolved in a safe manner by the shooter: - Remain in the shooting booth. - Keep the firearm pointed downrange. - Raise your non-shooting hand to signal a Range Safety Officer that you are in need of assistance.

20. If you observe an unsafe condition, report it to a Range Safety Officer immediately.

21. Upon the command of “CEASE FIRE“ stop shooting immediately and engage the safety. Place your firearm on the table or ground pointing downrange and back away from the shooting booth. Do not under any circumstances re-approach the firing line or touch your firearm until the command of “ALL CLEAR“ is given.

22. All range commands given by Range Safety Officers must be obeyed immediately and without question. Range commands are non-negotiable.

23. Shooters may collect their personal shot brass within the confines of the shooting booth once they have cleared and locked their firearm in their case. Shooters must remain behind the firing line at all times.

24. RSO’s must approve all targets used on the range. Targets deemed inappropriate by RSO are prohibited. Acceptable targets are available for purchase in our store.

25. Wash your hands and face after leaving the range.

26. Be kind to your fellow shooters. Act responsible at all times. Foul language, horseplay or any other unsafe activity will not be tolerated. Shooters may be held financially responsible for range damage caused by improper or negligent use of a firearm.

27. No open toed shoes or sandals.

I have read and understand the Range Safety Rules for Smokin’ Barrel Guns

Date: April 18, 2021

First Participant's Name

First Name*

Middle Name

Last Name*
First Participant's Date of Birth*
First Participant's Information

Please answer the following questions.

1. Are you under indictment or information (information is a formal accusation of a crime made by a prosecuting attorney) in any court for a crime for which a Judge could imprison you for more than one (1) year? *
No
2. Have you been convicted in any court of a crime for which a Judge could have imprisoned you for more than one (1) year, even if the Judge actually gave you a shorter sentence? *
No
3. Are you a fugitive from justice? *
No
4. Have you ever been adjudicated mentally defective or have you been committed to a mental institution? *
No
5. Have you been discharged from the Armed Forces under dishonorable conditions? *
No
6. Are you an alien illegally in the United States? *
No
7. Are you subject to a court order restraining you from harassing, stalking, or threatening another person? *
No
8. Have you been convicted in any court of domestic violence? This includes, but is not limited to, any conviction involving the use or attempted use of physical force committed by a current or former spouse, parent, guardian or child of the victim by a person with similar relationship with the victim. *
No
9. Are you addicted to, or an unlawful user of marijuana, any depressant, stimulant, narcotic drug or any other controlled substance? *
No
10. Are you depressed and/or do you want to cause harm to yourself or others? *
No

I certify that the above answers are true and correct. I understand that a person who answers "yes" to any of the above questions is prohibited from possessing or renting a firearm. I understand that making a false or written statement or the exhibiting of any false or misrepresented identification with respect to this transaction is unlawful and I will be held liable. I further certify that I am experienced and skilled in the proper handling, loading, use and discharge of all firearms and ammunition I intend to use at this range. 

The Undersigned agrees that he/she is financially responsible for any damages incurred to the rental firearm and facilities by misuse/improper handling of rental firearm or by use of unauthorized ammunition in said firearm. By signing this instrument, the Undersigned affirms that he/she has read, understands, and will comply with the requirements as set for herein, and do hereby agree to defend, indemnify, and hold harmless Smokin' Barrel Guns Inc., and its officers, directors, owners, partners, agents, brokers, employees, insurers, assigns, administrators, assignees or heirs, and all other related person, entities, affiliates, predecessors, and successors, from any act or omission for which the Undersigned is directly responsible. 

This instrument binds the Undersigned and his/her executors,


Driver License # (if N/A, use State ID # or Passport #)

Expiration Date
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Please answer the following questions.

1. Are you under indictment or information (information is a formal accusation of a crime made by a prosecuting attorney) in any court for a crime for which a Judge could imprison you for more than one (1) year? *
No
2. Have you been convicted in any court of a crime for which a Judge could have imprisoned you for more than one (1) year, even if the Judge actually gave you a shorter sentence? *
No
3. Are you a fugitive from justice? *
No
4. Have you ever been adjudicated mentally defective or have you been committed to a mental institution? *
No
5. Have you been discharged from the Armed Forces under dishonorable conditions? *
No
6. Are you an alien illegally in the United States? *
No
7. Are you subject to a court order restraining you from harassing, stalking, or threatening another person? *
No
8. Have you been convicted in any court of domestic violence? This includes, but is not limited to, any conviction involving the use or attempted use of physical force committed by a current or former spouse, parent, guardian or child of the victim by a person with similar relationship with the victim. *
No
9. Are you addicted to, or an unlawful user of marijuana, any depressant, stimulant, narcotic drug or any other controlled substance? *
No
10. Are you depressed and/or do you want to cause harm to yourself or others? *
No

I certify that the above answers are true and correct. I understand that a person who answers "yes" to any of the above questions is prohibited from possessing or renting a firearm. I understand that making a false or written statement or the exhibiting of any false or misrepresented identification with respect to this transaction is unlawful and I will be held liable. I further certify that I am experienced and skilled in the proper handling, loading, use and discharge of all firearms and ammunition I intend to use at this range. 

The Undersigned agrees that he/she is financially responsible for any damages incurred to the rental firearm and facilities by misuse/improper handling of rental firearm or by use of unauthorized ammunition in said firearm. By signing this instrument, the Undersigned affirms that he/she has read, understands, and will comply with the requirements as set for herein, and do hereby agree to defend, indemnify, and hold harmless Smokin' Barrel Guns Inc., and its officers, directors, owners, partners, agents, brokers, employees, insurers, assigns, administrators, assignees or heirs, and all other related person, entities, affiliates, predecessors, and successors, from any act or omission for which the Undersigned is directly responsible. 

This instrument binds the Undersigned and his/her executors,


Driver License # (if N/A, use State ID # or Passport #)

Expiration Date
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Please answer the following questions.

1. Are you under indictment or information (information is a formal accusation of a crime made by a prosecuting attorney) in any court for a crime for which a Judge could imprison you for more than one (1) year? *
No
2. Have you been convicted in any court of a crime for which a Judge could have imprisoned you for more than one (1) year, even if the Judge actually gave you a shorter sentence? *
No
3. Are you a fugitive from justice? *
No
4. Have you ever been adjudicated mentally defective or have you been committed to a mental institution? *
No
5. Have you been discharged from the Armed Forces under dishonorable conditions? *
No
6. Are you an alien illegally in the United States? *
No
7. Are you subject to a court order restraining you from harassing, stalking, or threatening another person? *
No
8. Have you been convicted in any court of domestic violence? This includes, but is not limited to, any conviction involving the use or attempted use of physical force committed by a current or former spouse, parent, guardian or child of the victim by a person with similar relationship with the victim. *
No
9. Are you addicted to, or an unlawful user of marijuana, any depressant, stimulant, narcotic drug or any other controlled substance? *
No
10. Are you depressed and/or do you want to cause harm to yourself or others? *
No

I certify that the above answers are true and correct. I understand that a person who answers "yes" to any of the above questions is prohibited from possessing or renting a firearm. I understand that making a false or written statement or the exhibiting of any false or misrepresented identification with respect to this transaction is unlawful and I will be held liable. I further certify that I am experienced and skilled in the proper handling, loading, use and discharge of all firearms and ammunition I intend to use at this range. 

The Undersigned agrees that he/she is financially responsible for any damages incurred to the rental firearm and facilities by misuse/improper handling of rental firearm or by use of unauthorized ammunition in said firearm. By signing this instrument, the Undersigned affirms that he/she has read, understands, and will comply with the requirements as set for herein, and do hereby agree to defend, indemnify, and hold harmless Smokin' Barrel Guns Inc., and its officers, directors, owners, partners, agents, brokers, employees, insurers, assigns, administrators, assignees or heirs, and all other related person, entities, affiliates, predecessors, and successors, from any act or omission for which the Undersigned is directly responsible. 

This instrument binds the Undersigned and his/her executors,


Driver License # (if N/A, use State ID # or Passport #)

Expiration Date
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Please answer the following questions.

1. Are you under indictment or information (information is a formal accusation of a crime made by a prosecuting attorney) in any court for a crime for which a Judge could imprison you for more than one (1) year? *
No
2. Have you been convicted in any court of a crime for which a Judge could have imprisoned you for more than one (1) year, even if the Judge actually gave you a shorter sentence? *
No
3. Are you a fugitive from justice? *
No
4. Have you ever been adjudicated mentally defective or have you been committed to a mental institution? *
No
5. Have you been discharged from the Armed Forces under dishonorable conditions? *
No
6. Are you an alien illegally in the United States? *
No
7. Are you subject to a court order restraining you from harassing, stalking, or threatening another person? *
No
8. Have you been convicted in any court of domestic violence? This includes, but is not limited to, any conviction involving the use or attempted use of physical force committed by a current or former spouse, parent, guardian or child of the victim by a person with similar relationship with the victim. *
No
9. Are you addicted to, or an unlawful user of marijuana, any depressant, stimulant, narcotic drug or any other controlled substance? *
No
10. Are you depressed and/or do you want to cause harm to yourself or others? *
No

I certify that the above answers are true and correct. I understand that a person who answers "yes" to any of the above questions is prohibited from possessing or renting a firearm. I understand that making a false or written statement or the exhibiting of any false or misrepresented identification with respect to this transaction is unlawful and I will be held liable. I further certify that I am experienced and skilled in the proper handling, loading, use and discharge of all firearms and ammunition I intend to use at this range. 

The Undersigned agrees that he/she is financially responsible for any damages incurred to the rental firearm and facilities by misuse/improper handling of rental firearm or by use of unauthorized ammunition in said firearm. By signing this instrument, the Undersigned affirms that he/she has read, understands, and will comply with the requirements as set for herein, and do hereby agree to defend, indemnify, and hold harmless Smokin' Barrel Guns Inc., and its officers, directors, owners, partners, agents, brokers, employees, insurers, assigns, administrators, assignees or heirs, and all other related person, entities, affiliates, predecessors, and successors, from any act or omission for which the Undersigned is directly responsible. 

This instrument binds the Undersigned and his/her executors,


Driver License # (if N/A, use State ID # or Passport #)

Expiration Date
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Please answer the following questions.

1. Are you under indictment or information (information is a formal accusation of a crime made by a prosecuting attorney) in any court for a crime for which a Judge could imprison you for more than one (1) year? *
No
2. Have you been convicted in any court of a crime for which a Judge could have imprisoned you for more than one (1) year, even if the Judge actually gave you a shorter sentence? *
No
3. Are you a fugitive from justice? *
No
4. Have you ever been adjudicated mentally defective or have you been committed to a mental institution? *
No
5. Have you been discharged from the Armed Forces under dishonorable conditions? *
No
6. Are you an alien illegally in the United States? *
No
7. Are you subject to a court order restraining you from harassing, stalking, or threatening another person? *
No
8. Have you been convicted in any court of domestic violence? This includes, but is not limited to, any conviction involving the use or attempted use of physical force committed by a current or former spouse, parent, guardian or child of the victim by a person with similar relationship with the victim. *
No
9. Are you addicted to, or an unlawful user of marijuana, any depressant, stimulant, narcotic drug or any other controlled substance? *
No
10. Are you depressed and/or do you want to cause harm to yourself or others? *
No

I certify that the above answers are true and correct. I understand that a person who answers "yes" to any of the above questions is prohibited from possessing or renting a firearm. I understand that making a false or written statement or the exhibiting of any false or misrepresented identification with respect to this transaction is unlawful and I will be held liable. I further certify that I am experienced and skilled in the proper handling, loading, use and discharge of all firearms and ammunition I intend to use at this range. 

The Undersigned agrees that he/she is financially responsible for any damages incurred to the rental firearm and facilities by misuse/improper handling of rental firearm or by use of unauthorized ammunition in said firearm. By signing this instrument, the Undersigned affirms that he/she has read, understands, and will comply with the requirements as set for herein, and do hereby agree to defend, indemnify, and hold harmless Smokin' Barrel Guns Inc., and its officers, directors, owners, partners, agents, brokers, employees, insurers, assigns, administrators, assignees or heirs, and all other related person, entities, affiliates, predecessors, and successors, from any act or omission for which the Undersigned is directly responsible. 

This instrument binds the Undersigned and his/her executors,


Driver License # (if N/A, use State ID # or Passport #)

Expiration Date
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Please answer the following questions.

1. Are you under indictment or information (information is a formal accusation of a crime made by a prosecuting attorney) in any court for a crime for which a Judge could imprison you for more than one (1) year? *
No
2. Have you been convicted in any court of a crime for which a Judge could have imprisoned you for more than one (1) year, even if the Judge actually gave you a shorter sentence? *
No
3. Are you a fugitive from justice? *
No
4. Have you ever been adjudicated mentally defective or have you been committed to a mental institution? *
No
5. Have you been discharged from the Armed Forces under dishonorable conditions? *
No
6. Are you an alien illegally in the United States? *
No
7. Are you subject to a court order restraining you from harassing, stalking, or threatening another person? *
No
8. Have you been convicted in any court of domestic violence? This includes, but is not limited to, any conviction involving the use or attempted use of physical force committed by a current or former spouse, parent, guardian or child of the victim by a person with similar relationship with the victim. *
No
9. Are you addicted to, or an unlawful user of marijuana, any depressant, stimulant, narcotic drug or any other controlled substance? *
No
10. Are you depressed and/or do you want to cause harm to yourself or others? *
No

I certify that the above answers are true and correct. I understand that a person who answers "yes" to any of the above questions is prohibited from possessing or renting a firearm. I understand that making a false or written statement or the exhibiting of any false or misrepresented identification with respect to this transaction is unlawful and I will be held liable. I further certify that I am experienced and skilled in the proper handling, loading, use and discharge of all firearms and ammunition I intend to use at this range. 

The Undersigned agrees that he/she is financially responsible for any damages incurred to the rental firearm and facilities by misuse/improper handling of rental firearm or by use of unauthorized ammunition in said firearm. By signing this instrument, the Undersigned affirms that he/she has read, understands, and will comply with the requirements as set for herein, and do hereby agree to defend, indemnify, and hold harmless Smokin' Barrel Guns Inc., and its officers, directors, owners, partners, agents, brokers, employees, insurers, assigns, administrators, assignees or heirs, and all other related person, entities, affiliates, predecessors, and successors, from any act or omission for which the Undersigned is directly responsible. 

This instrument binds the Undersigned and his/her executors,


Driver License # (if N/A, use State ID # or Passport #)

Expiration Date
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Please answer the following questions.

1. Are you under indictment or information (information is a formal accusation of a crime made by a prosecuting attorney) in any court for a crime for which a Judge could imprison you for more than one (1) year? *
No
2. Have you been convicted in any court of a crime for which a Judge could have imprisoned you for more than one (1) year, even if the Judge actually gave you a shorter sentence? *
No
3. Are you a fugitive from justice? *
No
4. Have you ever been adjudicated mentally defective or have you been committed to a mental institution? *
No
5. Have you been discharged from the Armed Forces under dishonorable conditions? *
No
6. Are you an alien illegally in the United States? *
No
7. Are you subject to a court order restraining you from harassing, stalking, or threatening another person? *
No
8. Have you been convicted in any court of domestic violence? This includes, but is not limited to, any conviction involving the use or attempted use of physical force committed by a current or former spouse, parent, guardian or child of the victim by a person with similar relationship with the victim. *
No
9. Are you addicted to, or an unlawful user of marijuana, any depressant, stimulant, narcotic drug or any other controlled substance? *
No
10. Are you depressed and/or do you want to cause harm to yourself or others? *
No

I certify that the above answers are true and correct. I understand that a person who answers "yes" to any of the above questions is prohibited from possessing or renting a firearm. I understand that making a false or written statement or the exhibiting of any false or misrepresented identification with respect to this transaction is unlawful and I will be held liable. I further certify that I am experienced and skilled in the proper handling, loading, use and discharge of all firearms and ammunition I intend to use at this range. 

The Undersigned agrees that he/she is financially responsible for any damages incurred to the rental firearm and facilities by misuse/improper handling of rental firearm or by use of unauthorized ammunition in said firearm. By signing this instrument, the Undersigned affirms that he/she has read, understands, and will comply with the requirements as set for herein, and do hereby agree to defend, indemnify, and hold harmless Smokin' Barrel Guns Inc., and its officers, directors, owners, partners, agents, brokers, employees, insurers, assigns, administrators, assignees or heirs, and all other related person, entities, affiliates, predecessors, and successors, from any act or omission for which the Undersigned is directly responsible. 

This instrument binds the Undersigned and his/her executors,


Driver License # (if N/A, use State ID # or Passport #)

Expiration Date
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Please answer the following questions.

1. Are you under indictment or information (information is a formal accusation of a crime made by a prosecuting attorney) in any court for a crime for which a Judge could imprison you for more than one (1) year? *
No
2. Have you been convicted in any court of a crime for which a Judge could have imprisoned you for more than one (1) year, even if the Judge actually gave you a shorter sentence? *
No
3. Are you a fugitive from justice? *
No
4. Have you ever been adjudicated mentally defective or have you been committed to a mental institution? *
No
5. Have you been discharged from the Armed Forces under dishonorable conditions? *
No
6. Are you an alien illegally in the United States? *
No
7. Are you subject to a court order restraining you from harassing, stalking, or threatening another person? *
No
8. Have you been convicted in any court of domestic violence? This includes, but is not limited to, any conviction involving the use or attempted use of physical force committed by a current or former spouse, parent, guardian or child of the victim by a person with similar relationship with the victim. *
No
9. Are you addicted to, or an unlawful user of marijuana, any depressant, stimulant, narcotic drug or any other controlled substance? *
No
10. Are you depressed and/or do you want to cause harm to yourself or others? *
No

I certify that the above answers are true and correct. I understand that a person who answers "yes" to any of the above questions is prohibited from possessing or renting a firearm. I understand that making a false or written statement or the exhibiting of any false or misrepresented identification with respect to this transaction is unlawful and I will be held liable. I further certify that I am experienced and skilled in the proper handling, loading, use and discharge of all firearms and ammunition I intend to use at this range. 

The Undersigned agrees that he/she is financially responsible for any damages incurred to the rental firearm and facilities by misuse/improper handling of rental firearm or by use of unauthorized ammunition in said firearm. By signing this instrument, the Undersigned affirms that he/she has read, understands, and will comply with the requirements as set for herein, and do hereby agree to defend, indemnify, and hold harmless Smokin' Barrel Guns Inc., and its officers, directors, owners, partners, agents, brokers, employees, insurers, assigns, administrators, assignees or heirs, and all other related person, entities, affiliates, predecessors, and successors, from any act or omission for which the Undersigned is directly responsible. 

This instrument binds the Undersigned and his/her executors,


Driver License # (if N/A, use State ID # or Passport #)

Expiration Date
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Please answer the following questions.

1. Are you under indictment or information (information is a formal accusation of a crime made by a prosecuting attorney) in any court for a crime for which a Judge could imprison you for more than one (1) year? *
No
2. Have you been convicted in any court of a crime for which a Judge could have imprisoned you for more than one (1) year, even if the Judge actually gave you a shorter sentence? *
No
3. Are you a fugitive from justice? *
No
4. Have you ever been adjudicated mentally defective or have you been committed to a mental institution? *
No
5. Have you been discharged from the Armed Forces under dishonorable conditions? *
No
6. Are you an alien illegally in the United States? *
No
7. Are you subject to a court order restraining you from harassing, stalking, or threatening another person? *
No
8. Have you been convicted in any court of domestic violence? This includes, but is not limited to, any conviction involving the use or attempted use of physical force committed by a current or former spouse, parent, guardian or child of the victim by a person with similar relationship with the victim. *
No
9. Are you addicted to, or an unlawful user of marijuana, any depressant, stimulant, narcotic drug or any other controlled substance? *
No
10. Are you depressed and/or do you want to cause harm to yourself or others? *
No

I certify that the above answers are true and correct. I understand that a person who answers "yes" to any of the above questions is prohibited from possessing or renting a firearm. I understand that making a false or written statement or the exhibiting of any false or misrepresented identification with respect to this transaction is unlawful and I will be held liable. I further certify that I am experienced and skilled in the proper handling, loading, use and discharge of all firearms and ammunition I intend to use at this range. 

The Undersigned agrees that he/she is financially responsible for any damages incurred to the rental firearm and facilities by misuse/improper handling of rental firearm or by use of unauthorized ammunition in said firearm. By signing this instrument, the Undersigned affirms that he/she has read, understands, and will comply with the requirements as set for herein, and do hereby agree to defend, indemnify, and hold harmless Smokin' Barrel Guns Inc., and its officers, directors, owners, partners, agents, brokers, employees, insurers, assigns, administrators, assignees or heirs, and all other related person, entities, affiliates, predecessors, and successors, from any act or omission for which the Undersigned is directly responsible. 

This instrument binds the Undersigned and his/her executors,


Driver License # (if N/A, use State ID # or Passport #)

Expiration Date
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Please answer the following questions.

1. Are you under indictment or information (information is a formal accusation of a crime made by a prosecuting attorney) in any court for a crime for which a Judge could imprison you for more than one (1) year? *
No
2. Have you been convicted in any court of a crime for which a Judge could have imprisoned you for more than one (1) year, even if the Judge actually gave you a shorter sentence? *
No
3. Are you a fugitive from justice? *
No
4. Have you ever been adjudicated mentally defective or have you been committed to a mental institution? *
No
5. Have you been discharged from the Armed Forces under dishonorable conditions? *
No
6. Are you an alien illegally in the United States? *
No
7. Are you subject to a court order restraining you from harassing, stalking, or threatening another person? *
No
8. Have you been convicted in any court of domestic violence? This includes, but is not limited to, any conviction involving the use or attempted use of physical force committed by a current or former spouse, parent, guardian or child of the victim by a person with similar relationship with the victim. *
No
9. Are you addicted to, or an unlawful user of marijuana, any depressant, stimulant, narcotic drug or any other controlled substance? *
No
10. Are you depressed and/or do you want to cause harm to yourself or others? *
No

I certify that the above answers are true and correct. I understand that a person who answers "yes" to any of the above questions is prohibited from possessing or renting a firearm. I understand that making a false or written statement or the exhibiting of any false or misrepresented identification with respect to this transaction is unlawful and I will be held liable. I further certify that I am experienced and skilled in the proper handling, loading, use and discharge of all firearms and ammunition I intend to use at this range. 

The Undersigned agrees that he/she is financially responsible for any damages incurred to the rental firearm and facilities by misuse/improper handling of rental firearm or by use of unauthorized ammunition in said firearm. By signing this instrument, the Undersigned affirms that he/she has read, understands, and will comply with the requirements as set for herein, and do hereby agree to defend, indemnify, and hold harmless Smokin' Barrel Guns Inc., and its officers, directors, owners, partners, agents, brokers, employees, insurers, assigns, administrators, assignees or heirs, and all other related person, entities, affiliates, predecessors, and successors, from any act or omission for which the Undersigned is directly responsible. 

This instrument binds the Undersigned and his/her executors,


Driver License # (if N/A, use State ID # or Passport #)

Expiration Date
Parent or Guardian's Email Address

Email*

Confirm Email*
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How did you hear about us?
Non-Guardian Escort Authorization

I do hereby authorize and give permission for the NON-Guardian(s) named below, to accompany and directly supervise ALL minor(s) stated herein, all activities at the Corporation, including classes or shooting on the range.  This authorization for named individuals will remain in effect until each minor reaches the age of majority or until such time that I remove a person.  Removing someone only effects future dates and does not effect past actions.

Non-Guardians must be 21 years of age or older.  They include family such as Grandparents, Brothers/Sisters, Aunts/Uncles, and friends.

The Photo ID(s) of the non-guardian(s) must be presented at the time of Check-In.

DO NOT complete this section unless you are Authorizing a Non-Parent/Non-Guardian to ESCORT your Minor Child on the Range. 


Enter [Name, Photo ID # of Non-Guardian escorts]

Authorization Date
If the Undersigned is UNDER 18 (MINOR), please complete the following Authorization for minor to use facility with Adult/Guardian present: I, (Adult/Guardian), of (Minor) give my written consent for the above individual to participate in the shooting of firearms at Smokin’ Barrel Guns Inc.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Please answer the following questions.

1. Are you under indictment or information (information is a formal accusation of a crime made by a prosecuting attorney) in any court for a crime for which a Judge could imprison you for more than one (1) year? *
No
2. Have you been convicted in any court of a crime for which a Judge could have imprisoned you for more than one (1) year, even if the Judge actually gave you a shorter sentence? *
No
3. Are you a fugitive from justice? *
No
4. Have you ever been adjudicated mentally defective or have you been committed to a mental institution? *
No
5. Have you been discharged from the Armed Forces under dishonorable conditions? *
No
6. Are you an alien illegally in the United States? *
No
7. Are you subject to a court order restraining you from harassing, stalking, or threatening another person? *
No
8. Have you been convicted in any court of domestic violence? This includes, but is not limited to, any conviction involving the use or attempted use of physical force committed by a current or former spouse, parent, guardian or child of the victim by a person with similar relationship with the victim. *
No
9. Are you addicted to, or an unlawful user of marijuana, any depressant, stimulant, narcotic drug or any other controlled substance? *
No
10. Are you depressed and/or do you want to cause harm to yourself or others? *
No

I certify that the above answers are true and correct. I understand that a person who answers "yes" to any of the above questions is prohibited from possessing or renting a firearm. I understand that making a false or written statement or the exhibiting of any false or misrepresented identification with respect to this transaction is unlawful and I will be held liable. I further certify that I am experienced and skilled in the proper handling, loading, use and discharge of all firearms and ammunition I intend to use at this range. 

The Undersigned agrees that he/she is financially responsible for any damages incurred to the rental firearm and facilities by misuse/improper handling of rental firearm or by use of unauthorized ammunition in said firearm. By signing this instrument, the Undersigned affirms that he/she has read, understands, and will comply with the requirements as set for herein, and do hereby agree to defend, indemnify, and hold harmless Smokin' Barrel Guns Inc., and its officers, directors, owners, partners, agents, brokers, employees, insurers, assigns, administrators, assignees or heirs, and all other related person, entities, affiliates, predecessors, and successors, from any act or omission for which the Undersigned is directly responsible. 

This instrument binds the Undersigned and his/her executors,


Driver License # (if N/A, use State ID # or Passport #)

Expiration Date
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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