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2540 BROWN AVE

MANCHESTER, NH 03103

 

 

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

Everyone who wishes to shoot firearms in this facility, whether using their own firearm or a rental firearm, or observe others shooting firearms MUST completely fill out this form. All information supplied will not be distributed to others and is for the sole use of Manchester Firing Line, LLC (“MFL”) and/or Iron Rose Womens Shooting Club, LLC (“Iron Rose”).

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. By entering on to the premises, you are granting your consent to be recorded via video and audio recording devices.

RANGE RULES AND SAFETY

1. Holstered firearms (both concealed and open) must 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 requires 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. All range fees will be due upon ejection, including time, rentals, ammunition and equipment.


11. Report any unsafe behavior to an MFL employee immediately.

In consideration for being granted access to the firing range, regardless of whether discharging firearms, the undersigned hereby releases MFL and Iron Rose, and the owners, managers, agents, officers, servants and employees of each (collectively, the “Releasees”), of and from, and waives, 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 and/or Iron Rose. The undersigned understands that as a result of signing this document, MFL and Iron Rose and the other released parties may act in manner which is negligent resulting in injury or death to the undersigned and the undersigned will not be able to sue or commence litigation against them as a result of such negligence and injury or death, and such is the intention of the undersigned.

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.

The undersigned acknowledges, understands and agrees that the undersigned shall have the sole responsibility for being aware of his or her surroundings and the actions and activities of those around him or her and the handling of firearms by those around him or her including the direction in which muzzles of firearms may be pointed, and the undersigned is not relying on the Releasees to supervise or monitor the actions of other users or to ensure that the other participants or users of shooting range facilities do not pose a danger to the undersigned and agrees that the Releasees have no duty to protect the undersigned from injury. The undersigned agrees and acknowledges that any expectation that participation in activities involving the use, handling and discharge of firearms does not pose a grave risk of death, harm or injury to the Participant is not a reasonable expectation.

I Agree

This release and waiver of liability is binding upon the undersigned and also the beneficiaries, 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.

CAUTION! THIS IS A RELEASE AND WAIVER OF LIABILITY. READ CAREFULLY BEFORE SIGNING. BY SIGNING THIS, YOU WAIVE THE RIGHT TO SUE FOR THINGS THAT HAPPEN IN THE FUTURE AND HAVE NOT YET OCCURRED.

THE UNDERSIGNED UNDERSTANDS AND AGREES THAT THIS RELEASE AND WAIVER OF LIABILITY CONSTITUTES A COMPLETE WAIVER OF THE RIGHT TO SUE AND COLLECT DAMAGES FROM MANCHESTER FIRING LINE LLC OR IRON ROSE WOMENS SHOOTING CLUB LLC OR THE OTHER RELEASED PARTIES, FOR ANY AND ALL DEATH, PERSONAL INJURY, AND/OR PROPERTY DAMAGE IN ANY WAY, EVEN WHEN THEY FAILED TO USE REASONABLE CARE, AND SUCH IS THE UNDERSIGNED’S INTENT.

THE INTENT OF MANCHESTER FIRING LINE LLC AND IRON ROSE WOMENS SHOOTING CLUB LLC AND THE OTHER RELEASED PARTIES IS THAT THIS RELEASE AND WAIVER OF LIABILITY WILL ALLOW THEM TO AVOID LIABILITY FOR ANY FAILURE ON THEIR PART TO USE REASONABLE CARE IN ANY WAY, AND THE UNDERSIGNED INTENDS TO ALLOW THEM TO AVOID SUCH LIABILITY.

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

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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