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Shooting Range Waiver

PLEASE READ CAREFULLY AND CHECK BOXES THEN SIGN WAIVER AT BOTTOM

I have never been convicted of or pled guilty to or entered a plea of nolo contendere or been convicted of a crime punishable by imprisonment for a term exceeding one year under the laws of any state of the United States other than a crime classified as a misdemeanor.

I have never been convicted of, or pled guilty to, one or more misdemeanor offenses involving crimes of violence or been convicted of two or more misdemeanor offenses involving driving while under the influence of intoxicating liquor or drugs or the possession or abuse of a controlled substance within a five year period.

I am not a fugitive from justice or currently charged in an information or indictment with the commission of a crime punishable by imprisonment for a term exceeding one year under the laws of any state of the United States.

I am not, nor have I ever actively participated in a street gang (Eg; Norteno, Sureno, MS, AB, Motorcycle Gang, Etc.)

I have never been discharged under dishonorable conditions from the United States Armed Forces.

I have never been adjudged mentally incompetent within the past five years or been committed to a mental health facility in California or a similar institution located in another state following a hearing at which you were represented by counsel or other representative.

I have never been convicted of the crime of domestic violence and I am not currently under the order of a court for threatening, stalking, harassing, violence or other crimes.

I am not currently addicted to illegal drugs which include, marijuana, methamphetamine, cocaine, or opiates (prescription or non-prescription). Marijuana users are restricted from using firearms per federal law and will not be allowed access to the rental guns, or ranges.

I am not at this time nor will I use the range at the Stage Stop Sporting Goods while under the influence of alcohol, drugs (including marijuana), or medication that may impair my judgment with firearms.

 

WHEREAS, in consideration of being permitted to shoot firearms at Stage Stop Sporting Goods, for use of premises, and for other good and valuable consideration, the receipt and sufficiently of which is hereby acknowledged, undersigned agrees to the following:

Undersigned agrees to indemnify, hold harmless and defend JH Verna Inc (DBA: Stage Stop Sporting Goods / Stage Stop Gun Shop), and their agents (hereafter referred to as Staff), from any and all fault, liabilities, costs, expenses, claims, demands, or lawsuits arising out of, related to or connected with: undersigneds presence at and/or participation in the course of instruction; the discharge of firearms by undersigned; undersigneds presence on or use of the range, building, land, and premises; and, any and all acts or omissions of undersigned.

Undersigned hereby expressly assumes the risk of taking part in the range activities with firearms and taking part in the activities on the premises, which include, but are not limited to the use of firearms, the discharge of firearms and the firing of live ammunition.

Stage Stop Gun Shop - RANGE SAFETY RULES

1. No one is allowed on the range under the influence of alcohol or any other controlled substance or marijuana.

2. No loaded firearms are to enter or exit the building. Load and unload firearms at firing line only. No firearms are permitted in the store area without being in a locked container. We do encourage On or Off Duty Law Enforcement and Concealed Weapons Permit holders to carry. Please only remove your firearm from holster/concealment while inside a range booth. Do not expose or unholster a gun anywhere outside of the range booth.

3. Firearms may be inspected at the check-in counter at the request of Stage Stop Gun Shop staff.  Any firearms or ammunition found to be unsafe or un-serviceable will not be allowed on the range.

4. All handguns and rifles are subject to approval.

5. Two shooters are allowed per lane. No spectators allowed in the shooting bay. All persons entering the range will be charged accordingly.

6. Eye and ear protection must be worn at ALL TIMES on the range. All persons on range must wear shoes that cover entire foot, and shirts must be able to prevent hot brass from falling in shirt.

7. Targets not purchased at Stage Stop must be approved prior to use on our range. Shooting at anything other than your own target is strictly prohibited.

8. No head shots for inexperienced shooters. Shots must be a minimum of 10 inches below the target hangers.

9. Drawing from a holster is not permitted.

10. The muzzle of all firearms must be kept pointed downrange at all times. If leaving the range temporarily, leave all firearms on the firing line unloaded with the magazine removed, action open, and the muzzle pointing downrange.

11. All personal firearms must arrive to the facility and leave the shooting station bench unloaded and in a case. No uncased firearms may leave the shooting station bench.

12. If a misfire or other malfunction occurs, keep the firearm pointed downrange and signal the range staff. Place the firearm on the bench pointed downrange, and obtain assistance. DO NOT leave the firing line with a loaded or jammed firearm.

13. All ammunition is subject to inspection and approval

        A. Allowable calibers are: Handguns, .22 rimfire through .50 caliber. Rifles that are chambered .308 or smaller or chambered for handgun ammunition.

        B. NO STEEL CORE, INCENDIARY, OR EXPLOSIVE AMMUNITIONS ARE ALLOWED.

       C. NO SHOTGUNS: All gauges, buckshot, slugs and birdshot are not allowed.

14. Stage Stop Gun Shop and its staff shall not be held liable for any damages incurred from use of ammunition. Customer will resolve any issues with the manufacturer of the product.

15. No fast or rapid firing allowed. Allow at least 1 second between shots. Any hazardous behavior WILL RESULT IN IMMEDIATE DISMISSAL FROM THE PREMISES.

16. Comply with all instructions from the range staff.

17. Report any unsafe conduct to the range staff immediately.

18. No brass that has fallen to the floor of the range shall be removed from the range without written permission by management of Stage Stop Sporting Goods. Please notify the cashier during check-in.

19. Any violation of range safety rules will result in IMMEDIATE REPRIMAND and possible DISMISSAL from the range

20. Only ammunition purchased at Stage Stop Sporting Goods will be allowed for rental firearms.

21. THERE WILL BE NO REFUNDS OF ANY KIND FOR PARTIES EXPELLED FROM THE RANGE.

I have read the above statements and understand the rules and regulations of JH Verna Inc (DBA: Stage Stop Sporting Goods / Stage Stop Gun Shop).

I will fully comply with all the above statements.

JH Verna Inc (DBA: Stage Stop Sporting Goods / Stage Stop Gun Shop) rules are subject to change.

Initial here to agree to range safety rules

 

Undersigned furthermore waives for himself/herself and for his/her executors, personal representatives, administrators, assignees, heirs and next of kin, any and all rights and claims for damages, losses, demands and any other actions or claims whatsoever, which he/she may have or which may arise against JH Verna Inc (DBA: Stage Stop Sporting Goods / Stage Stop Gun Shop) and staff (including but not limited to the death of undersigned and/or any and all injuries damages or illnesses suffered by undersigned or undersigneds property), which may, in any way whatsoever, arise out of, be related to or be connected with: the course of instruction; the premises, including any latent defect in the premises; undersigneds presence on or use of said premises; undersigneds property; and the discharge of firearms. Instructor shall not be liable for, and undersigned, on behalf of himself/herself and on behalf of his/her executors, personal representatives, administrators, assignees, heirs, and next of kin, hereby expressly releases the instructor from any and all such claims and liabilities.

 

All classes will have firearms requirements. ALL MICRO PISTOLS (32cal 25cal 22LR) MUST BE APPROVED BY TRAINING STAFF. For Basic and NON Certificate classes you can use guns that are not registered to you. For the Certified (CCW) classes you must bring no more than 3 guns that are registered in your own name. Acceptable caliber weapons include, 22lr, 9mm, 10mm, 40SW, 45ACP, 45GAP, 357SIG, 357MAG, 38SPC (+P). It is highly recommended that all guns are cleaned and property lubricated before coming to the range. If you have any questions, please contact dmartens@ssgs.us or come by the store during regular business hours.

I Agree

Undersigned agrees to reimburse JH Verna Inc (DBA: Stage Stop Sporting Goods / Stage Stop Gun Shop), and their agents (hereafter referred to as Staff), from any and all fault, liabilities, costs, expenses, caused by damaging or destroying range facilities, equipment property. The list of costs for replacing damaged items will be available at the gun rental counter.

I Agree

 

Course/Range Safety Rules

Do not bring any ammunition into the classroom.

All firearms to be in LOCKED case at class.

Do not point a firearm at anyone.

Do not point a firearm at anything you do not wish to shoot.

Do not put your finger on the trigger until ready to shoot.

Keep all firearms unloaded until ready to shoot.

 

Course Policies

Safety violations will not be tolerated and may result in ejection from the class.

No refund will be given to students failing to adhere to safety standards.

Students failing the CCW courses will not be issued a refund. Students will be offered the opportunity to retake the course within the calendar year at half price.

You will need to provide your own ammunition.

You must have eye and ear safety protection (safety equipment).

Signing below indicates that you have read and understand the Course Safety Rules and Course Policies and attached Release, Waiver, Indemnification, Hold Harmless, and Assumption of the Risk Agreement.

 

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

WHEREAS, in consideration of being permitted to attend a course for instruction in firearms, for the instruction in firearms, for use of premises, and for other good and valuable consideration, the receipt and sufficiently of which is hereby acknowledged, Undersigned agrees to the following:

Undersigned agrees to indemnify, hold harmless and defend JH Verna Inc (DBA: Stage Stop Sporting Goods / Stage Stop Gun Shop), and their agents (hereafter referred to as Instructor), from any and all fault, liabilities, costs, expenses, claims, demands, or lawsuits arising out of, related to or connected with: Undersigneds presence at and/or participation in the course of instruction; the discharge of firearms by Undersigned;

Undersigneds presence on or use of the range, building, land, and premises (Premises); and, any and all acts or omissions of Undersigned.

Undersigned furthermore waives for himself/herself and for his/her executors, personal representatives, administrators, assignees, heirs and next of kin, any and all rights and claims for: damages, losses, demands and any other actions or claims whatsoever, which he/she may have or which may arise against Instructor (including but not limited to the death of Undersigned and/or any and all injuries damages or illnesses suffered by Undersigned or Undersigneds property), which may, in any way whatsoever, arise out of, be related to or be connected with: the course of instruction; the Premises, including any latent defect in the Premises; Undersigneds presence on or use of said Premises; Undersigneds property (whether or not entrusted to Instructor); and the discharge of firearms. Instructor shall not be liable for, and Undersigned, on behalf of himself/herself and on behalf of his/her executors, personal representatives, administrators, assignees, heirs, and next of kin, hereby expressly releases the instructor from any and all such claims and liabilities.

Undersigned hereby expressly assumes the risk of taking part in the course for instruction in firearms and taking part in the activities on the Premises, which include, but are not limited to instruction in the use of firearms, the discharge of firearms and the firing of live ammunition.

Undersigned hereby acknowledges and agrees that Undersigned has read this instrument and understands its terms and is executing this instrument voluntarily. Undersigned furthermore hereby acknowledges and agrees that he/she has read, understands and will at all times abide by all range rules and procedures and any other rules and procedures stated by the Instructor.

Undersigned expressly agrees that this instrument is intended to be as broad and inclusive as permitted by law and that if any provision of this instrument is held invalid or otherwise unenforceable, the enforceability of the remaining provision shall not be impaired thereby. No remedy conferred by any of the specific provision of this instrument is intended to be exclusive of any other remedy, and each and every remedy shall be cumulative and shall be in addition to every other remedy nor or hereafter existing at law or in equity or by statute or otherwise. The election of any one or more remedy hereunder by the Instructor shall not constitute any waiver of Instructors right to pursue other available remedies. This instrument binds Undersigned and his/her executors, personal representatives, administrators, assignees, heirs and next of kin.

November 17, 2018

[signed]

 

First Participant's Name

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Third Participant's Name

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Fourth Participant's Name

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Fifth Participant's Name

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Sixth Participant's Name

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Seventh Participant's Name

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Eighth Participant's Name

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Tenth Participant's Name

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Parent or Guardian's Email Address

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A signed copy of this waiver will be sent to the email address you provide.
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This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of JH Verna Inc (DBA: Stage Stop Sporting Goods / Stage Stop Gun Shop) and staff, and for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless JH Verna Inc (DBA: Stage Stop Sporting Goods / Stage Stop Gun Shop) and staff from any and all liabilities incident to my minor child’s involvement or participation in these events and activities and/or the use of related real and personal property as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE. 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.
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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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