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HURON VALLEY GUNS WAIVER FORM

Application, Release and Indemnification Agreement

Participation in the use of the Huron Valley Gun Ranges requires physical stamina, motor coordination, and mental alertness. The undersigned hereby attests that he/she has no known physical or mental limitations and further attests that he/she has not used any form of alcohol, prescription or non-prescription drugs that could, or is, impairing his/her performance at the Gun Range, or has not been convicted of any felony and/or domestic violence.

Participant must show driver’s license or state ID and allow for digital scanning of the identification for tracking purposes.

PLEASE READ THIS ENTIRE AGREEMENT, INITIAL BELOW, CHECK THE APPROPRIATE BOXES AND SIGN AND DATE WHERE INDICATED ON THE REVERSE SIDE

  • DRUGS AND/OR ALCOHOL USE IS STRICTLY PROHIBITED; USING THE GUN RANGE UNDER THE INFLUENCE OF DRUGS AND/OR ALCOHOL IS STRICTLY PROHIBTED.
  • No food or beverages are allowed in the range area.
  • Eye and ear protection must be worn at all times.
  • It is recommended that users of the Gun Range have medical insurance at the time of participation. Huron Valley Guns LLC will not cover any medical expenses associated with your use of the Gun Range.
  • When entering the Gun Range, please be sure that the outer door is closed prior to opening the inner door.
  • All rental firearms entering or leaving the range are a must be UNLOADED with actions open and magazines removed from firearm.
  • Personal firearms must be unloaded and cased, or with current CPL, holstered and concealed, until in the range.
  • No firing from a holster is permitted unless specifically authorized by a Gun Range employee.
  • FIREARMS MUST BE POINTED DOWN RANGE AT ALL TIMES AND NEVER HIGHER THAN THE TARGET.
  • Un-aimed and uncontrolled fire is strictly prohibited. All shots must be fired at approved targets.
  • Any shots striking an overhead baffle will result in a ten-dollar ($10.00) fine. Failure to report such incident may jeopardize your future use of the Gun Range.
  • ALL AMMUNITION AND FIREARMS ARE SUBJECT TO INSPECTION PRIOR TO USE.
  • Only Gun Range provided ammunition is to be used in Gun Range rental firearms.
  • Handgun caliber ammunition & rimfire ammunition are only on pistol ranges.
  • JACKETED AMMUNITION ONLY. NO LEAD OR CAST BULLETS OR ARMOR PIERCING OR STEEL CORE OR TRACER AMMUNITION ALLOWED ON THE GUN RANGE.
  • NO RAPID FIRE. One second rule applies (1 round per second). Without prior approval from management.
  • No handling of firearms by customers at any time except when on the firing line at their assigned shooting position or when assisted by Staff.
  • Only one person may fire from a booth at a time. Shooters may trade lanes to try other firearms.
  • Any shooter is allowed to call a cease-fire for any safety violation, anytime.
  • ANY TIME A CEASE FIRE IS CALLED, PLACE YOUR FIREARM ONTHE BENCH AND BACKAWAY FROM THE FIRING LINE IMMEDIATELY.  ALL PISTOL RANGE RULES APPLY TO THE USE OF THE RIFLE RANGE AS WELL.
  • NO PISTOLS WILL BE FIRED ON THE RIFLE RANGE.
  • Please remove and dispose of all debris when leaving the Gun Range. You can only remove the brass fired from your gun.
  • GUN RANGE EMPLOYEES HAVE UNQUESTIONABLE AUTHORITY REGARDING THE GUN RANGE.
  • I have read and hereby agree to conduct myself according to the rules listed above, in addition to any rules which may be posted and/or applied by the Gun Range staff, at all times during my use of the Huron Valley Gun Range. 

In consideration of HURON VALLEY GUNS LLC., including, without limitation, its members, employees, officers, agents, third party supplier furnishing services, equipment (including rented guns and protective gear), and/or curriculum allowing me to participate in use of the Huron Valley Gun Range, I agree as follows:

I. LEGAL RELEASE, ASSUMPTION OF RISK, WAIVER AND COVENANT NOT TO SUE AGREEMENT

I fully understand and acknowledge: (a) there are DANGERS AND RISK OF PERSONAL INJURY, PROPERTY DAMAGE, DISEASE AND/OR DEATH arising from my use of the Gun Range and/or my participation in gun education and training activities; (b) participation in such activities and/or use of provided equipment may result in PERSONAL INJURY, PROPERTY DAMAGE, DISEASE AND/OR DEATH; (c) any of the foregoing may be caused by negligence and may arise from foreseeable or unforeseeable causes; I understand that firearms are mechanical devices which are susceptible to unexpected breakage and/or failure and that the same may result in PERSONAL INJURY, PROPERTY DAMAGE, DISEASE AND/OR DEATH; (d) by participating in these activities and/or using the equipment and gun range, I, on behalf of myself, my personal representatives and my successors, hereby assume all risks and all responsibility related to my participation, and agree to release Huron Valley Guns for any injuries, losses, damages and/or death however caused. I agree and understand that, on behalf of myself, my personal representatives and my successors, I relinquish any and all rights I now have or may have in the future to sue Huron Valley Guns LLC for any and all injury, damage, or death I may suffer arising from use of the Gun Range or rented guns or other equipment, including claims based on negligence.

II. INDEMNIFICATION AND HOLD HARMLESS

I, on behalf of myself, my personal representatives and my heirs, agree to hold harmless, defend, and indemnify Huron Valley Guns LLC its officials, employees, students, volunteers and others working in behalf of Huron Valley Guns LLC against any and all claims, demands, suits, or loss, including all costs connected therewith, and for any damages which may be asserted, claimed or recovered against or from the Huron Valley Guns LLC, its administrators, employees, volunteers or others working in behalf of the Huron Valley Guns LLC by reason of personal injury, including bodily injury and death and/or property damage, including loss of use thereof, which arises out of the negligence of the Huron Valley Guns LLC in association with the use of the Gun Range, rented guns, or other equipment.

I HAVE READ THIS APPLICATION, RELEASE AND INDEMNIFICATION AGREEMENTIN ITS ENTIRETY AND HEREBY AGREE TO ITS TERMS. I AGREE TO ASSUME ALL RISKS AND RELEASE HURON VALLEY GUNS LLC FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE, DISEASE OR DEATH, HOWEVER CAUSED, ARISING FROM MY USE OF THE GUN RANGE. I AGREE TO ACCEPT LEGAL RESPONSIBILITY FOR ANY LOSS FOR CLAIMS OR LAWSUITS AGAINST HURON VALLEY GUNS LLC ARISING FROM MY USE OF THE GUN RANGE. I ACKNOWLEDGE THAT THIS APPLICATION, RELEASE AND INDEMNIFICATION AGREEMENT SHALL APPLY TO, AND SHALL BE ENFORCEABLE WITH REGARD TO, EACH AND EVERY TIME I VISIT AND/OR USE THE GUN RANGE.

I have had the opportunity to ask any questions about the indemnification and hold harmless section and I understand its terms and meaning. All information provided by me is complete and accurate.

Dated: November 22, 2019

By signing this form you are now a entry level member of Huron Valley Guns.

First Participant's Name

First Name*

Middle Name

Last Name*

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

AGE: *

PLEASE ACCURATELY CHECK THE APPROPRIATE BOX BELOW:

I would rate my previous experience with firearms as:*
Have you ever been adjudicated as mentally defective, committed to a mental institution or have any mental health issues or history?*
Are you an user of marijuana (lawful or unlawful) or any depressant, stimulant, or narcotic drug or any other controlled substance or under the influence of any of the above?*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

AGE: *

PLEASE ACCURATELY CHECK THE APPROPRIATE BOX BELOW:

I would rate my previous experience with firearms as:*
Have you ever been adjudicated as mentally defective, committed to a mental institution or have any mental health issues or history?*
Are you an user of marijuana (lawful or unlawful) or any depressant, stimulant, or narcotic drug or any other controlled substance or under the influence of any of the above?*
Third Participant's Name

First Name*

Middle Name

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

AGE: *

PLEASE ACCURATELY CHECK THE APPROPRIATE BOX BELOW:

I would rate my previous experience with firearms as:*
Have you ever been adjudicated as mentally defective, committed to a mental institution or have any mental health issues or history?*
Are you an user of marijuana (lawful or unlawful) or any depressant, stimulant, or narcotic drug or any other controlled substance or under the influence of any of the above?*
Fourth Participant's Name

First Name*

Middle Name

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

AGE: *

PLEASE ACCURATELY CHECK THE APPROPRIATE BOX BELOW:

I would rate my previous experience with firearms as:*
Have you ever been adjudicated as mentally defective, committed to a mental institution or have any mental health issues or history?*
Are you an user of marijuana (lawful or unlawful) or any depressant, stimulant, or narcotic drug or any other controlled substance or under the influence of any of the above?*
Fifth Participant's Name

First Name*

Middle Name

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

AGE: *

PLEASE ACCURATELY CHECK THE APPROPRIATE BOX BELOW:

I would rate my previous experience with firearms as:*
Have you ever been adjudicated as mentally defective, committed to a mental institution or have any mental health issues or history?*
Are you an user of marijuana (lawful or unlawful) or any depressant, stimulant, or narcotic drug or any other controlled substance or under the influence of any of the above?*
Sixth Participant's Name

First Name*

Middle Name

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

AGE: *

PLEASE ACCURATELY CHECK THE APPROPRIATE BOX BELOW:

I would rate my previous experience with firearms as:*
Have you ever been adjudicated as mentally defective, committed to a mental institution or have any mental health issues or history?*
Are you an user of marijuana (lawful or unlawful) or any depressant, stimulant, or narcotic drug or any other controlled substance or under the influence of any of the above?*
Seventh Participant's Name

First Name*

Middle Name

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

AGE: *

PLEASE ACCURATELY CHECK THE APPROPRIATE BOX BELOW:

I would rate my previous experience with firearms as:*
Have you ever been adjudicated as mentally defective, committed to a mental institution or have any mental health issues or history?*
Are you an user of marijuana (lawful or unlawful) or any depressant, stimulant, or narcotic drug or any other controlled substance or under the influence of any of the above?*
Eighth Participant's Name

First Name*

Middle Name

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

AGE: *

PLEASE ACCURATELY CHECK THE APPROPRIATE BOX BELOW:

I would rate my previous experience with firearms as:*
Have you ever been adjudicated as mentally defective, committed to a mental institution or have any mental health issues or history?*
Are you an user of marijuana (lawful or unlawful) or any depressant, stimulant, or narcotic drug or any other controlled substance or under the influence of any of the above?*
Ninth Participant's Name

First Name*

Middle Name

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

AGE: *

PLEASE ACCURATELY CHECK THE APPROPRIATE BOX BELOW:

I would rate my previous experience with firearms as:*
Have you ever been adjudicated as mentally defective, committed to a mental institution or have any mental health issues or history?*
Are you an user of marijuana (lawful or unlawful) or any depressant, stimulant, or narcotic drug or any other controlled substance or under the influence of any of the above?*
Tenth Participant's Name

First Name*

Middle Name

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

AGE: *

PLEASE ACCURATELY CHECK THE APPROPRIATE BOX BELOW:

I would rate my previous experience with firearms as:*
Have you ever been adjudicated as mentally defective, committed to a mental institution or have any mental health issues or history?*
Are you an user of marijuana (lawful or unlawful) or any depressant, stimulant, or narcotic drug or any other controlled substance or under the influence of any of the above?*
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.
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
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*

Middle Name

Last Name*

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

AGE: *

PLEASE ACCURATELY CHECK THE APPROPRIATE BOX BELOW:

I would rate my previous experience with firearms as:*
Have you ever been adjudicated as mentally defective, committed to a mental institution or have any mental health issues or history?*
Are you an user of marijuana (lawful or unlawful) or any depressant, stimulant, or narcotic drug or any other controlled substance or under the influence of any of the above?*
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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