Loading...

Carolina Sporting Arms
Registration Form and Liability Waiver

 

FEMALE PARTICIPANTS:  Women who are pregnant are not allowed to shoot in the CSA range.

***Please note:  All guests aged 18 to 20 are permitted to shoot long guns/rifles ONLY if shooting alone.  If a guest between 18 - 20 is accompanied by a parent or legal guardian, the guest may shoot handguns with the parent or guardian present.

This form must be completed prior to shooting.

Note: Signing this form is voluntary; however, participation in all shooting activities is dependent on signing this form. 

If you have been convicted of a felony (including first time offenders), you are not permitted to shoot on the range. 

Absolutely no alcohol, illegal substances or legal medications that would impair your judgment, vision or hearing may be ingested before or while participating in this activity.    

I Agree
 

 LIABILITY WAIVER AND ASSUMPTION OF RISK 

I have registered and anticipate full participation in the activities and training provided and in consideration of the services of Carolina Sporting Arms, (further referred to herein as “CSA”) its agents, instructor(s), officers, representatives, directors, volunteers, participants, employees, staff and all other persons or entitled acting in any capacity on behalf of CSA. I hereby fully acknowledge, understand, agree to, release and hold harmless CSA on behalf of myself, acting agents representing both real or personal property, heirs, next of kin, assigns, personal representatives and estate and acknowledge each Article as follows: 

  • I acknowledge the risks and dangers that exist in my use of any/all firearms and/or defensive tactics and techniques, and assume the risk(s) which could result in physical and/or emotional injury, paralysis, death, or damage to myself, to property, or to third-parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity(ies). The risk(s) include, but are not limited to, among other things: the undersigned or third-parties being shot by a firearm; suffering hearing loss, eye injury or loss, inhalation or contact with airborne contaminants and or flying debris, and being struck anywhere on my person (body). Furthermore, I understand that the CSA staff, have a difficult job to perform and while the CSA staff seeks safety, the CSA staff is not infallible. The CSA staff may be unaware of a participant’s fitness or abilities. The CSA staff may give inadequate warnings or instructions, and the equipment used may malfunction. I expressly agree and promise to accept all of the risks existing in this activity. Participation in this activity is purely voluntary, and I elect to participate in spite of the risks. I agree to indemnify and hold harmless CSA, its agents, officers, representatives, directors, officers, volunteers, participants, employees, and staff against loss or expense including attorney’s fees, by reason of the liability imposed by law upon CSA. It is further understood and agreed that this WAIVER AND ASSUMPTION OF RISK shall (at the option of CSA) defend CSA with appropriate counsel and shall further bear all costs and expenses, including the expense of counsel in the defense of any litigation, mediation and or arbitration suit arising hereunder. It is further agreed that all disputes shall be submitted to binding litigation or arbitration within the State of North Carolina’s jurisdiction and venue of CSAʼs registered office and settled in accordance with the rules of the Court or the American Arbitration Association. I hereby voluntarily release CSA, its agents, officers, representatives, directors, officers, volunteers, participants, employees, and staff, forever (discharge) and agree to indemnify and hold harmless from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of any equipment or facilities including any and all, but not limited to, indoor or outdoor shooting ranges, including any such claims Carolina Sporting Arms which allege negligent acts or omissions of CSA its agents, officers, representatives, directors, officers, volunteers, participants, staff and employees.
  • I agree to be personally responsible for my own safety, and the safety of any minors in my care while on the range. I agree to follow all instructions given by CSA staff immediately, except if I should have any reservations about any of the CSA staffʼs instructions, I shall, while maintaining safety for myself and others, immediately notify of such. I may choose NOT to participate in any activity that I deem unsafe. I additionally acknowledge that the CSA staff may, at any time, make a judgment call such as but not limited to safety or disorderly conduct, and should I fail to correct my actions after being warned, the CSA staff may use their own discretion and determine whether or not I may continue with the activity. Upon termination I understand that I will have to leave the activity/facility immediately and not be entitled to any refund of monies paid and all materials presented to me on that day or any related materials/equipment to the activity will be returned as property of CSA. I agree that if I am not capable of completing the required demands and/or functions of the activity, I am required to immediately advise the CSA staff. I agree to perform the techniques taught at no greater speed or force level that I am comfortable with and competent at. If unsure of the proper technique, I shall ask for assistance from CSA staff and shall not improvise techniques on my own. 
  • I agree to make every effort to keep all activity areas safe. Should I become aware of any potentially unsafe aspect of the activity area (such as the indoor shooting ranges or training room), including unsafe behavior of other participants, I agree to immediately notify the CSA staff. I shall immediately notify CSA staff of any injury that I receive, or that I observe injury to any other participant. 
  • I agree when arriving, departing and while on CSA property, I must keep all firearm(s) unloaded and cased. Except Law Enforcement and valid Concealed Carry Handgun license holder. When not cased (such as a rental gun), handguns, rifles and shotguns must be carried unloaded with actions open in the muzzle down position, detachable magazines removed/tubes unloaded, with an inserted chamber safety flag. Actions can only be "closed" on an inserted chamber safety flag. 
  • Should a STAFF or any person present at a CSA activity provide transportation in connection with this activity, I acknowledge that such transportation is provided solely as a convenience to me and that it is not part of the activity and that the CSA STAFF, agents, employees, and staff has no responsibility or liability in connection with the transportation.
  • I specifically release the shooting range owner/operator, the activity sponsor(s) and staff, guest instructors, CSA staff, all individuals participating in the administration of the activity, and the Officers and Directors of the shooting range from any and all claims or liability related to the activities in which I am choosing to participate. I agree to indemnify the above mentioned entities and individuals for any and all expenses and liability they incur as a result of any of my conduct related to the CSA activity.          
  1. I certify that I have not been convicted of domestic violence or subject to a domestic violence protective order. 
  2. I certify that I am not drug or alcohol dependent. 
  3. I certify that I have not been adjudicated incompetent and have not been committed to a mental institution.
  4. I certify that I have never been dishonorably discharged from the Armed Forces. 
  5. I certify that I am not an alien illegally in the United States 
  6. I certify that I am not a fugitive from justice, nor under indictment in any Court. I also certify that I have not been convicted of a felony, misdemeanor or any crime. 

I certify that all of the above statements are true.  

I expressly agree that the foregoing Liability Waiver and Release is intended to be as broad as is permitted by the laws of the State of North Carolina. I further agree that if any provisions of this agreement are held to be invalid, nevertheless, the balance of the agreement shall continue in full force and effect.  WHEREFORE, I have had sufficient opportunity to read this entire document, I acknowledge and understand the LIABILITY WAIVER, RELEASE AND ASSUMPTION OF RISK and fully understand its terms. I understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing this agreement freely and voluntarily and intend my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.    

 Today's Date: April 18, 2024

Please choose "Adult" if you are 18 or over. Please remember that any adult aged 18 - 21 can only shoot long guns unless accompanied by a parent or guardian.
AdultAdult and Minor(s)
1 Minor2 Minors3 Minors4 Minors5 MinorsMore Minors6 Minors7 Minors8 Minors9 Minors10 Minors
Continue
First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's Date of Birth*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail. Your email will remain confidential and will not be sold or given away to entities outside of CSA.
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
FOR FEMALE PARTICIPANTS ONLY:
I certify that I am not pregnant.
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.
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!