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2540 BROWN AVE

MANCHESTER, NH 03103

 

 

MANCHESTER FIRING LINE, LLC.
FIREARMS EXPERIENCE, RANGE SAFETY AND RELEASE

Everyone who wishes to shoot in this facility, whether using their own firearm or a rental firearm MUST completely fill out this form. All information supplied will be kept strictly confidential, not distributed or made available to others for any purpose and is for the sole use of “Manchester Firing Line, LLC.” ( MFL) to properly identify the user and document their previous firearms experience. This is being done to best ensure the safety of all range users.

NOTICE: All activities in/and around this facility are recorded with video & audio monitoring equipment. Information listed on this form can, and will be used, to solve crimes committed against this facility.

RANGE RULES AND SAFETY

  1. Holstered firearms (both concealed and open) should remain holstered until reaching your lane
  2. Eye and ear protection is mandatory at all times while on the range.
  3. Transport of firearms between the lobby and range require the firearm to be unloaded, magazine out, chamber open. Rented handguns need to be transported in the baskets provided. Long guns should be transported with the muzzle pointed up.
  4. While on the range, only one person may shoot in a lane at a time. No firearm may be handed off to another individual while loaded.
  5. All firearms must be treated as loaded firearms, and only pointed down-range while on the firing line.
  6. Targets should be placed between chest and eye level of each shooter. No cross lane shooting.
  7. No steel core or armor piercing ammunition. If in doubt, please check with a clerk. Range damage charges will be applied if this ammo is used.
  8. You must shoot in a controlled manner. If you hit the floor, ceiling, walls, bench or target carrier you are not in control.
  9. Damage to the range whether intentional or not, will be assessed a minimum charge of $25.00.

  10. MFL reserves the right to remove anyone from the range for any reason, including unsafe acts, damage to premises and unruly behavior.
  11. Report any unsafe behavior to a MFL employee immediately.

Upon receiving permission from MFL. to enter the premises of this firing range and in further consideration of receiving permission to participate in the use of the firing range, in any appropriate and lawful capacity, the undersigned hereby releases MFL, it’s agents, officers, servants and employees of and from any and all liability, claims, demands, actions and causes of action whatsoever arising out of and related to any loss, damage or injury, including death, that may be sustained by the undersigned while in or on our premises or any leased to, owned by or sanctioned, or under the control or supervision of MFL.

The undersigned being duly aware of the risks and hazards inherent upon entering said premises and/or in participating in any appropriate and lawful uses thereof, hereby elects voluntarily to enter upon said premises, knowing their present condition and knowing said condition may become more hazardous and dangerous during the time that the undersigned is upon said premises.

This release shall be binding upon the distributes, heirs, next of kin, executors and administrators of the undersigned. In signing the foregoing release, the undersigned hereby acknowledges and represents:

  1. That he/she had read the foregoing release, understands it and signs it voluntarily.
  2. That he/she is 18 years of age or older or if under 18 years of age is in the accompaniment of an adult who assumes all responsibility for the minor and his/her actions.

IN WITNESS THEREOF, the undersigned has hereunto set his hand.

Today's Date: April 3, 2026

First Customer's Name
First Name*
Last Name*
Phone*
Select Gender
First Customer's Date of Birth*
Date of Birth
Information
MEMBER CARD #
MEMBER
NON-MEMBER
LAW ENFORCEMENT
MILITARY
1ST RESPONDER
Please rate your experience for: Handguns*
Please rate your experience for: Rifles*
Please rate your experience for: Machine Guns*
Have you ever been committed to a mental institute or had a history of mental illness or have any pending domestic violence petition against you?*
Are you an unlawful user, or addicted to, or under the influence of marijuana or any depressant, stimulant, narcotic drug or any other controlled substance?*
Have you ever been convicted of a felony?*
Are you pregnant?*
First Customer's Signature*
Second Customer's Name
First Name*
Last Name*
Select Gender
Customer's Date of Birth*
Date of Birth
Information
MEMBER CARD #
MEMBER
NON-MEMBER
LAW ENFORCEMENT
MILITARY
1ST RESPONDER
Please rate your experience for: Handguns*
Please rate your experience for: Rifles*
Please rate your experience for: Machine Guns*
Have you ever been committed to a mental institute or had a history of mental illness or have any pending domestic violence petition against you?*
Are you an unlawful user, or addicted to, or under the influence of marijuana or any depressant, stimulant, narcotic drug or any other controlled substance?*
Have you ever been convicted of a felony?*
Are you pregnant?*
Third Customer's Name
First Name*
Last Name*
Select Gender
Customer's Date of Birth*
Date of Birth
Information
MEMBER CARD #
MEMBER
NON-MEMBER
LAW ENFORCEMENT
MILITARY
1ST RESPONDER
Please rate your experience for: Handguns*
Please rate your experience for: Rifles*
Please rate your experience for: Machine Guns*
Have you ever been committed to a mental institute or had a history of mental illness or have any pending domestic violence petition against you?*
Are you an unlawful user, or addicted to, or under the influence of marijuana or any depressant, stimulant, narcotic drug or any other controlled substance?*
Have you ever been convicted of a felony?*
Are you pregnant?*
Fourth Customer's Name
First Name*
Last Name*
Select Gender
Customer's Date of Birth*
Date of Birth
Information
MEMBER CARD #
MEMBER
NON-MEMBER
LAW ENFORCEMENT
MILITARY
1ST RESPONDER
Please rate your experience for: Handguns*
Please rate your experience for: Rifles*
Please rate your experience for: Machine Guns*
Have you ever been committed to a mental institute or had a history of mental illness or have any pending domestic violence petition against you?*
Are you an unlawful user, or addicted to, or under the influence of marijuana or any depressant, stimulant, narcotic drug or any other controlled substance?*
Have you ever been convicted of a felony?*
Are you pregnant?*
Fifth Customer's Name
First Name*
Last Name*
Select Gender
Customer's Date of Birth*
Date of Birth
Information
MEMBER CARD #
MEMBER
NON-MEMBER
LAW ENFORCEMENT
MILITARY
1ST RESPONDER
Please rate your experience for: Handguns*
Please rate your experience for: Rifles*
Please rate your experience for: Machine Guns*
Have you ever been committed to a mental institute or had a history of mental illness or have any pending domestic violence petition against you?*
Are you an unlawful user, or addicted to, or under the influence of marijuana or any depressant, stimulant, narcotic drug or any other controlled substance?*
Have you ever been convicted of a felony?*
Are you pregnant?*
Sixth Customer's Name
First Name*
Last Name*
Select Gender
Customer's Date of Birth*
Date of Birth
Information
MEMBER CARD #
MEMBER
NON-MEMBER
LAW ENFORCEMENT
MILITARY
1ST RESPONDER
Please rate your experience for: Handguns*
Please rate your experience for: Rifles*
Please rate your experience for: Machine Guns*
Have you ever been committed to a mental institute or had a history of mental illness or have any pending domestic violence petition against you?*
Are you an unlawful user, or addicted to, or under the influence of marijuana or any depressant, stimulant, narcotic drug or any other controlled substance?*
Have you ever been convicted of a felony?*
Are you pregnant?*
Seventh Customer's Name
First Name*
Last Name*
Select Gender
Customer's Date of Birth*
Date of Birth
Information
MEMBER CARD #
MEMBER
NON-MEMBER
LAW ENFORCEMENT
MILITARY
1ST RESPONDER
Please rate your experience for: Handguns*
Please rate your experience for: Rifles*
Please rate your experience for: Machine Guns*
Have you ever been committed to a mental institute or had a history of mental illness or have any pending domestic violence petition against you?*
Are you an unlawful user, or addicted to, or under the influence of marijuana or any depressant, stimulant, narcotic drug or any other controlled substance?*
Have you ever been convicted of a felony?*
Are you pregnant?*
Eighth Customer's Name
First Name*
Last Name*
Select Gender
Customer's Date of Birth*
Date of Birth
Information
MEMBER CARD #
MEMBER
NON-MEMBER
LAW ENFORCEMENT
MILITARY
1ST RESPONDER
Please rate your experience for: Handguns*
Please rate your experience for: Rifles*
Please rate your experience for: Machine Guns*
Have you ever been committed to a mental institute or had a history of mental illness or have any pending domestic violence petition against you?*
Are you an unlawful user, or addicted to, or under the influence of marijuana or any depressant, stimulant, narcotic drug or any other controlled substance?*
Have you ever been convicted of a felony?*
Are you pregnant?*
Ninth Customer's Name
First Name*
Last Name*
Select Gender
Customer's Date of Birth*
Date of Birth
Information
MEMBER CARD #
MEMBER
NON-MEMBER
LAW ENFORCEMENT
MILITARY
1ST RESPONDER
Please rate your experience for: Handguns*
Please rate your experience for: Rifles*
Please rate your experience for: Machine Guns*
Have you ever been committed to a mental institute or had a history of mental illness or have any pending domestic violence petition against you?*
Are you an unlawful user, or addicted to, or under the influence of marijuana or any depressant, stimulant, narcotic drug or any other controlled substance?*
Have you ever been convicted of a felony?*
Are you pregnant?*
Tenth Customer's Name
First Name*
Last Name*
Select Gender
Customer's Date of Birth*
Date of Birth
Information
MEMBER CARD #
MEMBER
NON-MEMBER
LAW ENFORCEMENT
MILITARY
1ST RESPONDER
Please rate your experience for: Handguns*
Please rate your experience for: Rifles*
Please rate your experience for: Machine Guns*
Have you ever been committed to a mental institute or had a history of mental illness or have any pending domestic violence petition against you?*
Are you an unlawful user, or addicted to, or under the influence of marijuana or any depressant, stimulant, narcotic drug or any other controlled substance?*
Have you ever been convicted of a felony?*
Are you pregnant?*
Customer'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
Check to receive information, news, and discounts by e-mail.
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
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.


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*
Select Gender
Parent or Guardian's Date of Birth*
Date of Birth
Information
MEMBER CARD #
MEMBER
NON-MEMBER
LAW ENFORCEMENT
MILITARY
1ST RESPONDER
Please rate your experience for: Handguns*
Please rate your experience for: Rifles*
Please rate your experience for: Machine Guns*
Have you ever been committed to a mental institute or had a history of mental illness or have any pending domestic violence petition against you?*
Are you an unlawful user, or addicted to, or under the influence of marijuana or any depressant, stimulant, narcotic drug or any other controlled substance?*
Have you ever been convicted of a felony?*
Are you pregnant?*
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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