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PRE ADMISSION CERTIFICATION, WAIVER OF LIABILITY, INDEMNIFICATION, GENERAL RELEASE AND ASSUMPTION

All first time range visitors, whether using personal firearms, or rental firearms from Bullet and Barrel, llc, MUST complete this form. This information will be kept confidential, not distributed or made available in anyway to others for any purpose, and is for the sole use of Bullet and Barrel, llc for the purpose of identifying range users, and documenting identification and previous firearms experience. Employee and visitor safety is our primary concern.

YOU MUST HAVE A VALID STATE OR FEDERAL ISSUED ID AND BE 18 YEARS OR OLDER TO RENT A FIREARM. WE FOLLOW ALL STATE AND FEDERAL LAWS. SOME FIREARMS ARE RESTRICTED TO PATRONS UNDER THE AGE OF 21.

ANYONE SUSPECTED OF ALCOHOL OR DRUG USE WILL NOT BE ALLOWED ON THE RANGE. WE RESERVE THE RIGHT TO REQUEST A BREATHALYZER TEST.

Dated: November 26, 2020

(PLEASE READ THIS DOCUMENT CAREFULLY. IT IS A LEGALLY BINDING AGREEMENT)

I UNDERSTAND THAT FIREARMS AND THE USE OF FIREARMS ARE INHERENTLY DANGEROUS AND THAT USE OF OR PROXIMITY TO THE USE OF SUCH CAN RESULT IN SERIOUS INJURY OR DEATH TO ME AND THOSE WITH ME.

BY SIGNING THIS AGREEMENT I AM GIVING UP MY RIGHT TO BRING A COURT ACTION, RECOVER COMPENSATION OR OBTAIN ANY OTHER REMEDY FOR INJURIES TO MYSELF, OTHERS WITH ME, OR MY PROPERTY ARISING OUT OF MY USE OF BULLET AND BARREL, LLC FOR ANY INJURY, INCLUDING PARALYSIS OR DEATH, CAUSED IN WHOLE OR IN PART BY THE ACTS OR OMISSIONS OF BULLET AND BARREL, INCLUDING ANY OF ITS AGENTS, EMPLOYEES AND EQUIPMENT, NOW OR ANYTIME IN THE FUTURE.

In consideration of being allowed to participate in the services and activities, including, but not limited to, shooting range access, shooting range activities and any other activities (collectively “ACTIVITIES”), provided by BULLET AND BARREL, LLC and its agents, owners, officers, directors, principals, volunteers, participants, clients, customers, invitees, employees, independent contractors, insurers, facility operators, land and/or premises owners, and any and all other persons and entities acting in any capacity on its behalf (collectively “BULLET AND BARREL”),I, on behalf of myself, hereby agree to forever release, indemnify and discharge BULLET AND BARREL on behalf of myself, my spouse, legal partner, my children, my parents, my guardians, heirs, assigns, personal representatives and estate, and all other persons and entities as set forth below. I represent that (i) I am in good health and in proper physical condition to participate in the activities in which BULLET AND BARREL provides; and (ii) I am not under the influence of alcohol or any illicit or prescription drugs which would in any way impair my ability to safely participate in activities; (iii) I have not been advised against shooting activities by a health professional. I agree that it is my sole responsibility to determine whether I am sufficiently fit and healthy enough to participate in activities. The undersigned, for myself agree to be familiar with and to abide by the rules established for the ACTIVITIES, which include without limitation the rules posted in the facility and the website, and are part of the BULLET AND BARREL Registration Packet. I agree to attend a security briefing in the form of a range video prior to my first use of the Bullet and Barrel range.

(1) RELEASE OF LIABILITY:  Despite all known and unknown risks including but not limited to serious bodily injury, permanent disability, paralysis and loss of life, I, on behalf of myself, hereby expressly and voluntarily remise, release, acquit, satisfy and forever discharge and agree not to take action against or sue BULLET AND BARREL, and agree to hold said parties harmless of and from any and all manner of actions or omission(s), causes of action, suits, sums of money, controversies, damages, judgments, executions, claims and demands whatsoever, in law or in equity, including, but not limited to, any and all claims which allege negligent acts and/or omissions committed by BULLET AND BARREL whether the action arises out of any damage, loss, personal injury, or death, while participating in or as a result of participating in any of the ACTIVITIES in or about the premises. This Release of Liability, is effective and valid regardless of whether the damage, loss or death is a result of any act or omission on the part of BULLET AND BARREL.

(2) INDEMNIFICATION : I understand that the known and unknown risks may be caused in whole or in part by me, the actions or inactions of others participating in activities, or the acts, inaction of BULLET AND BARREL and in consideration of being allowed to participate in the ACTIVITIES, I hereby assume all risk of damage, loss, personal injury, or death to as a result of the participation in ACTIVITIES in or about the facility, including any such loss due to any negligence of BULLET AND BARREL and agree to indemnify and hold harmless BULLET AND BARREL from and against any and all losses, liabilities, claims, obligations, costs, damages and/or expenses whatsoever paid, incurred and/or suffered by BULLET AND BARREL as a result of any claims asserted by myself against BULLET AND BARREL, including, but not limited to, any and all attorneys’ fees, costs, damages and/or judgments BULLET AND BARREL incurs in the event of such loss whether caused by the negligence of BULLET AND BARREL and that on behalf of myself. I further agree to indemnify and hold harmless BULLET AND BARREL for any injury, damage and/or harm to myself, caused by BULLET AND BARREL or its facility and/or to any and all other persons and entities acting in any capacity on behalf of BULLET AND BARREL.

I understand that the Range Safety Officers have the right and responsibility to remove me immediately and terminate my participation, if my actions are interpreted to threaten the safety or welfare of myself, other customers, employees or the range facilities. I hereby state I am under NO legal injunction that prohibits my owning, possessing, handling or using any of the firearms used in the events at BULLET AND BARREL.

(3) ATTORNEYS’ FEES : I promise to indemnify BULLET AND BARREL for any attorneys’ fees and/or costs incurred to enforce this agreement, including all costs associated with any collection efforts. Further, should any debt and/or judgment accrue in favor of BULLET AND BARREL, pre-judgement and post-judgement interest shall accrue thereon at a rate of 18% per annum, or as otherwise permitted by law.

(4) PHOTO RELEASE:  By entering BULLET AND BARREL and participating in the ACTIVITIES, I hereby grant BULLET AND BARREL on behalf of myself the irrevocable right and permission to photograph and/or record me in connection with BULLET AND BARREL and to use the photograph and/or recording for all purposes, including advertising and promotional purposes, in any manner and all media now or hereafter known, in perpetuity throughout the world, without restriction as to alteration. I waive any right to inspect or approve the use of the photograph and/or recording, and acknowledge and agree that the rights granted to this release are without compensation of any kind.

(5) TERMS OF AGREEMENT:  I understand that this agreement extends forever into the future and will have full force and legal effect each and every time I visit BULLET AND BARREL. The undersigned further expressly agrees that this agreement is intended to be as broad and inclusive as is permitted by the laws of this state and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

(6) VENUE:  In the event of a lawsuit, I agree to the sole and exclusive venue of Madison County, Alabama. I further agree that the substantive law of Alabama shall apply without regard to any conflict of law rules. (7) I understand and acknowledge that use of ammunition and firearms is an inherently dangerous activity and I execute this document in full knowledge of the same.

BY SIGNING THIS DOCUMENT, I UNDERSTAND THAT I MAY BE FOUND BY A COURT OF LAW TO HAVE FOREVER WAIVED MY RIGHT TO MAINTAIN ANY ACTION AGAINST BULLET AND BARREL ON THE BASIS OF ANY CLAIM FROM WHICH I HAVE RELEASED BULLET AND BARREL AND ANY RELEASED PARTY HEREIN AND THAT I HAVE ASSUMED ALL RISK OF DAMAGE, LOSS, PERSONAL INJURY, OR DEATH TO MYSELF AND AGREED TO INDEMNIFY AND HOLD HARMLESS BULLET AND BARREL FROM AND AGAINST ANY AND ALL LOSSES, LIABILITIES, CLAIMS, OBLIGATIONS, COSTS, DAMAGES AND/OR EXPENSES WHATSOEVER PAID, INCURRED AND/OR SUFFERED BY BULLET AND BARREL AS A RESULT OF THE PARTICIPATION IN ACTIVITIES IN OR ABOUT THE FACILITY BY MYSELF AND/OR CLAIMS ASSERTED BY MYSELF AGAINST BULLET AND BARREL RELATED TO SUCH PARTICIPATION IN ACTIVITIES. I HAVE HAD A REASONABLE AND SUFFICIENT OPPORTUNITY TO READ AND UNDERSTAND THIS ENTIRE DOCUMENT AND CONSULT WITH LEGAL COUNSEL, OR HAVE VOLUNTARILY WAIVED MY RIGHT TO DO SO. I KNOWINGLY AND VOLUNTARILY AGREE TO BE BOUND BY ALL TERMS AND CONDITIONS SET FORTH HEREIN.

You MUST be 19 years old or older to sign your own waiver .

You MUST be the Parent or Legal Guardian to sign for a minor (under age 19).

We reserve the right to review your license and/or other forms of ID to verify identity and age.

 

~~RANGE RULES

1.All Federal, State and Local firearms laws must be obeyed.
2.Participants must check with Range Counter before and after shooting.
3.Range Safety Officers may inspect all firearms and ammunition.
4.Commands issued by range staff must be obeyed.
5.Follow the Basic Rules of Firearm Safety at all times:
● Treat all guns as if they are loaded.
● Always point guns in a safe direction.
● Keep your finger off the trigger until you are ready to shoot.
6.A short safety video is required for all first-time users.
7.Eye and ear protection is required.
8.Firearms must be cleared with breech open, and placed in a carrier, when removed from the firing line. In addition, firearms must be unloaded until ready to use.
9.Rental firearms require B&B ammunition. You may bring your own ammo (we will inspect) to use in personal firearms. Reloaded ammunition requires permission from management.
10.Upon the command “CEASE FIRE”: stop all shooting immediately. Place firearm on the bench and back away from the firing line. Don’t approach the firing line or pick up firearm until the “ALL CLEAR” signal is given..
11.For any firearm or ammunition problem, place the firearm on the bench with muzzle pointed down range. To signal the RSO for assistance, step away from the bench and raise your hand.
12.Steel core, tracers, explosive, frangible or armor piercing ammunition is prohibited. Shotguns are permitted with approved ammunition only. Ammunition over 30-06 requires permission.
13.No shooting from the hip or from holsters. Long guns must have a shoulder stock.
14.The use of drugs or alcohol prior to visiting the range is prohibited.
15.Tobacco use, eating, chewing gum, and drinking in the range is prohibited.
16.Wanton or careless destruction of the range or systems, will result in a stiff fine and possible expulsion.
17.Any violation of safety rules or RSO instructions may result in immediate removal from the range.
18.Minors between the ages of 12 and 18, who have attended an approved training program are welcome with a parent or guardian. State law forbids minors between 18-21 from renting and purchasing certain firearms. Individuals over 18, but not yet 21, may use their own firearms within the confines of the law.

I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND ALL RANGE RULES AND REQUIREMENTS, AND AGREE TO ABIDE BY THEM.

I Agree

 

 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Member Number if applicable:

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*

Please list any firearms training:
HAVE YOU EVER BEEN ADJUDICATED AS MENTALLY DEFECTIVE, BEEN COMMITTED TO A MENTAL INSTITUTION OR DO YOU HAVE A HISTORY OF MENTAL ILLNESS?*
No
Yes
ARE YOU AN UNLAWFUL USER OF, ADDICTED TO MARIJUANA, DEPRESSANTS, STIMULANTS OR NARCOTIC DRUGS (PRESCRIBED OR ILLEGAL), OR ANY OTHER CONTROLLED SUBSTANCE?*
No
Yes
ARE YOU LAWFULLY ELIGIBLE TO BE IN POSSESSION OF A FIREARM?*
No
Yes

ALL AMMUNITION USED IN RENTAL GUNS MUST BE PURCHASED FROM BULLET AND BARREL.

I HAVE READ ALL RULES OF THE RANGE FOR BULLET AND BARREL*
No
Yes
I UNDERSTAND THAT I MUST WATCH THE SAFETY VIDEO AT BULLET AND BARREL BEFORE SHOOTING*
No
Yes
First Participant's Signature*
Second Participant's Name

First Name*

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

Member Number if applicable:

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*

Please list any firearms training:
HAVE YOU EVER BEEN ADJUDICATED AS MENTALLY DEFECTIVE, BEEN COMMITTED TO A MENTAL INSTITUTION OR DO YOU HAVE A HISTORY OF MENTAL ILLNESS?*
No
Yes
ARE YOU AN UNLAWFUL USER OF, ADDICTED TO MARIJUANA, DEPRESSANTS, STIMULANTS OR NARCOTIC DRUGS (PRESCRIBED OR ILLEGAL), OR ANY OTHER CONTROLLED SUBSTANCE?*
No
Yes
ARE YOU LAWFULLY ELIGIBLE TO BE IN POSSESSION OF A FIREARM?*
No
Yes

ALL AMMUNITION USED IN RENTAL GUNS MUST BE PURCHASED FROM BULLET AND BARREL.

I HAVE READ ALL RULES OF THE RANGE FOR BULLET AND BARREL*
No
Yes
I UNDERSTAND THAT I MUST WATCH THE SAFETY VIDEO AT BULLET AND BARREL BEFORE SHOOTING*
No
Yes
Second Participant's Signature*
Third Participant's Name

First Name*

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

Member Number if applicable:

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*

Please list any firearms training:
HAVE YOU EVER BEEN ADJUDICATED AS MENTALLY DEFECTIVE, BEEN COMMITTED TO A MENTAL INSTITUTION OR DO YOU HAVE A HISTORY OF MENTAL ILLNESS?*
No
Yes
ARE YOU AN UNLAWFUL USER OF, ADDICTED TO MARIJUANA, DEPRESSANTS, STIMULANTS OR NARCOTIC DRUGS (PRESCRIBED OR ILLEGAL), OR ANY OTHER CONTROLLED SUBSTANCE?*
No
Yes
ARE YOU LAWFULLY ELIGIBLE TO BE IN POSSESSION OF A FIREARM?*
No
Yes

ALL AMMUNITION USED IN RENTAL GUNS MUST BE PURCHASED FROM BULLET AND BARREL.

I HAVE READ ALL RULES OF THE RANGE FOR BULLET AND BARREL*
No
Yes
I UNDERSTAND THAT I MUST WATCH THE SAFETY VIDEO AT BULLET AND BARREL BEFORE SHOOTING*
No
Yes
Third Participant's Signature*
Fourth Participant's Name

First Name*

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

Member Number if applicable:

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*

Please list any firearms training:
HAVE YOU EVER BEEN ADJUDICATED AS MENTALLY DEFECTIVE, BEEN COMMITTED TO A MENTAL INSTITUTION OR DO YOU HAVE A HISTORY OF MENTAL ILLNESS?*
No
Yes
ARE YOU AN UNLAWFUL USER OF, ADDICTED TO MARIJUANA, DEPRESSANTS, STIMULANTS OR NARCOTIC DRUGS (PRESCRIBED OR ILLEGAL), OR ANY OTHER CONTROLLED SUBSTANCE?*
No
Yes
ARE YOU LAWFULLY ELIGIBLE TO BE IN POSSESSION OF A FIREARM?*
No
Yes

ALL AMMUNITION USED IN RENTAL GUNS MUST BE PURCHASED FROM BULLET AND BARREL.

I HAVE READ ALL RULES OF THE RANGE FOR BULLET AND BARREL*
No
Yes
I UNDERSTAND THAT I MUST WATCH THE SAFETY VIDEO AT BULLET AND BARREL BEFORE SHOOTING*
No
Yes
Fourth Participant's Signature*
Fifth Participant's Name

First Name*

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

Member Number if applicable:

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*

Please list any firearms training:
HAVE YOU EVER BEEN ADJUDICATED AS MENTALLY DEFECTIVE, BEEN COMMITTED TO A MENTAL INSTITUTION OR DO YOU HAVE A HISTORY OF MENTAL ILLNESS?*
No
Yes
ARE YOU AN UNLAWFUL USER OF, ADDICTED TO MARIJUANA, DEPRESSANTS, STIMULANTS OR NARCOTIC DRUGS (PRESCRIBED OR ILLEGAL), OR ANY OTHER CONTROLLED SUBSTANCE?*
No
Yes
ARE YOU LAWFULLY ELIGIBLE TO BE IN POSSESSION OF A FIREARM?*
No
Yes

ALL AMMUNITION USED IN RENTAL GUNS MUST BE PURCHASED FROM BULLET AND BARREL.

I HAVE READ ALL RULES OF THE RANGE FOR BULLET AND BARREL*
No
Yes
I UNDERSTAND THAT I MUST WATCH THE SAFETY VIDEO AT BULLET AND BARREL BEFORE SHOOTING*
No
Yes
Fifth Participant's Signature*
Sixth Participant's Name

First Name*

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

Member Number if applicable:

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*

Please list any firearms training:
HAVE YOU EVER BEEN ADJUDICATED AS MENTALLY DEFECTIVE, BEEN COMMITTED TO A MENTAL INSTITUTION OR DO YOU HAVE A HISTORY OF MENTAL ILLNESS?*
No
Yes
ARE YOU AN UNLAWFUL USER OF, ADDICTED TO MARIJUANA, DEPRESSANTS, STIMULANTS OR NARCOTIC DRUGS (PRESCRIBED OR ILLEGAL), OR ANY OTHER CONTROLLED SUBSTANCE?*
No
Yes
ARE YOU LAWFULLY ELIGIBLE TO BE IN POSSESSION OF A FIREARM?*
No
Yes

ALL AMMUNITION USED IN RENTAL GUNS MUST BE PURCHASED FROM BULLET AND BARREL.

I HAVE READ ALL RULES OF THE RANGE FOR BULLET AND BARREL*
No
Yes
I UNDERSTAND THAT I MUST WATCH THE SAFETY VIDEO AT BULLET AND BARREL BEFORE SHOOTING*
No
Yes
Sixth Participant's Signature*
Seventh Participant's Name

First Name*

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

Member Number if applicable:

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*

Please list any firearms training:
HAVE YOU EVER BEEN ADJUDICATED AS MENTALLY DEFECTIVE, BEEN COMMITTED TO A MENTAL INSTITUTION OR DO YOU HAVE A HISTORY OF MENTAL ILLNESS?*
No
Yes
ARE YOU AN UNLAWFUL USER OF, ADDICTED TO MARIJUANA, DEPRESSANTS, STIMULANTS OR NARCOTIC DRUGS (PRESCRIBED OR ILLEGAL), OR ANY OTHER CONTROLLED SUBSTANCE?*
No
Yes
ARE YOU LAWFULLY ELIGIBLE TO BE IN POSSESSION OF A FIREARM?*
No
Yes

ALL AMMUNITION USED IN RENTAL GUNS MUST BE PURCHASED FROM BULLET AND BARREL.

I HAVE READ ALL RULES OF THE RANGE FOR BULLET AND BARREL*
No
Yes
I UNDERSTAND THAT I MUST WATCH THE SAFETY VIDEO AT BULLET AND BARREL BEFORE SHOOTING*
No
Yes
Seventh Participant's Signature*
Eighth Participant's Name

First Name*

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

Member Number if applicable:

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*

Please list any firearms training:
HAVE YOU EVER BEEN ADJUDICATED AS MENTALLY DEFECTIVE, BEEN COMMITTED TO A MENTAL INSTITUTION OR DO YOU HAVE A HISTORY OF MENTAL ILLNESS?*
No
Yes
ARE YOU AN UNLAWFUL USER OF, ADDICTED TO MARIJUANA, DEPRESSANTS, STIMULANTS OR NARCOTIC DRUGS (PRESCRIBED OR ILLEGAL), OR ANY OTHER CONTROLLED SUBSTANCE?*
No
Yes
ARE YOU LAWFULLY ELIGIBLE TO BE IN POSSESSION OF A FIREARM?*
No
Yes

ALL AMMUNITION USED IN RENTAL GUNS MUST BE PURCHASED FROM BULLET AND BARREL.

I HAVE READ ALL RULES OF THE RANGE FOR BULLET AND BARREL*
No
Yes
I UNDERSTAND THAT I MUST WATCH THE SAFETY VIDEO AT BULLET AND BARREL BEFORE SHOOTING*
No
Yes
Eighth Participant's Signature*
Ninth Participant's Name

First Name*

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

Member Number if applicable:

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*

Please list any firearms training:
HAVE YOU EVER BEEN ADJUDICATED AS MENTALLY DEFECTIVE, BEEN COMMITTED TO A MENTAL INSTITUTION OR DO YOU HAVE A HISTORY OF MENTAL ILLNESS?*
No
Yes
ARE YOU AN UNLAWFUL USER OF, ADDICTED TO MARIJUANA, DEPRESSANTS, STIMULANTS OR NARCOTIC DRUGS (PRESCRIBED OR ILLEGAL), OR ANY OTHER CONTROLLED SUBSTANCE?*
No
Yes
ARE YOU LAWFULLY ELIGIBLE TO BE IN POSSESSION OF A FIREARM?*
No
Yes

ALL AMMUNITION USED IN RENTAL GUNS MUST BE PURCHASED FROM BULLET AND BARREL.

I HAVE READ ALL RULES OF THE RANGE FOR BULLET AND BARREL*
No
Yes
I UNDERSTAND THAT I MUST WATCH THE SAFETY VIDEO AT BULLET AND BARREL BEFORE SHOOTING*
No
Yes
Ninth Participant's Signature*
Tenth Participant's Name

First Name*

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

Member Number if applicable:

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*

Please list any firearms training:
HAVE YOU EVER BEEN ADJUDICATED AS MENTALLY DEFECTIVE, BEEN COMMITTED TO A MENTAL INSTITUTION OR DO YOU HAVE A HISTORY OF MENTAL ILLNESS?*
No
Yes
ARE YOU AN UNLAWFUL USER OF, ADDICTED TO MARIJUANA, DEPRESSANTS, STIMULANTS OR NARCOTIC DRUGS (PRESCRIBED OR ILLEGAL), OR ANY OTHER CONTROLLED SUBSTANCE?*
No
Yes
ARE YOU LAWFULLY ELIGIBLE TO BE IN POSSESSION OF A FIREARM?*
No
Yes

ALL AMMUNITION USED IN RENTAL GUNS MUST BE PURCHASED FROM BULLET AND BARREL.

I HAVE READ ALL RULES OF THE RANGE FOR BULLET AND BARREL*
No
Yes
I UNDERSTAND THAT I MUST WATCH THE SAFETY VIDEO AT BULLET AND BARREL BEFORE SHOOTING*
No
Yes
Tenth Participant's Signature*
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.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
How did you first hear about Bullet and Barrel?
Friend
Billboard
Youtube Ad
Radio
Print Ad
TV
Other
Hotel
Facebook
Google Search
Other Social Media
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 Information

Member Number if applicable:

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*

Please list any firearms training:
HAVE YOU EVER BEEN ADJUDICATED AS MENTALLY DEFECTIVE, BEEN COMMITTED TO A MENTAL INSTITUTION OR DO YOU HAVE A HISTORY OF MENTAL ILLNESS?*
No
Yes
ARE YOU AN UNLAWFUL USER OF, ADDICTED TO MARIJUANA, DEPRESSANTS, STIMULANTS OR NARCOTIC DRUGS (PRESCRIBED OR ILLEGAL), OR ANY OTHER CONTROLLED SUBSTANCE?*
No
Yes
ARE YOU LAWFULLY ELIGIBLE TO BE IN POSSESSION OF A FIREARM?*
No
Yes

ALL AMMUNITION USED IN RENTAL GUNS MUST BE PURCHASED FROM BULLET AND BARREL.

I HAVE READ ALL RULES OF THE RANGE FOR BULLET AND BARREL*
No
Yes
I UNDERSTAND THAT I MUST WATCH THE SAFETY VIDEO AT BULLET AND BARREL BEFORE SHOOTING*
No
Yes
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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