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RELEASE, WAIVER, INDEMNIFICATION, HOLD HARMLESS,

AND ASSUMPTION OF THE RISK AGREEMENT

WHEREAS, in return for use of premises and equipment, instruction in firearms and/or self-defense (the “Training”), and/or for other goods and valuables consideration (bought or sold), the receipt and sufficiency of which is hereby acknowledged, I (the “Undersigned”) agree to the following:

By signing below, the Undersigned acknowledges that I understand and know my rights, and am willing to waive them, and wish to proceed with participating in the Training.

The Undersigned understands that under C.R.S. § 13-21-111.8: Any person who engages in sport shooting activities at a qualifying sport shooting range, as defined under section 25-12-109 (2)(d), C.R.S., assumes the risk of injury or damage associated with sport shooting activities.

Training activities may include but are not limited to :

· firearms manipulations

· dry fire of firearms

· live fire of firearms

· strenuous movement

· standing, sitting, or kneeling for various times

· weather exposure

· exposure to lead, or hot gases, chemical irritants (pepper spray, solvents, gun oil)

· knife manipulations

· joint or pressure point manipulations

· punches, kicks, grabs, or shoves, Etcetera

· return fire drills

This may include some formal/informal touching. If this is a concern you may privately request in writing to not be involved in these actives by contacting Robert Neil at robert@3FDT.com

The Undersigned agrees to indemnify, hold harmless, absolve, and defend NRA Instructor Robert D. Neil Jr, his spouse, heirs and assigns, Threefold Defensive Training Inc, Threefold Defensive Training Staff (assisting instructors, or range safety officers), the National Rifle Association (henceforth known as the NRA) and any of its employees, directors, officers or agents, and the owner of any premises on which the training is conducted (the “Land Owner”), from any and all fault, liabilities, costs (including attorney fees), expenses, claims (including negligence), demands or lawsuits arising out of, related to or connected with the Training in any manner ( including travel to or from the Training) or in connection with the undersigned’s presence on the premises used in connection with the Training.

The Undersigned waives any and all rights and claims for damages, losses, demands and any other actions, which exist or which may arise against NRA Instructor Robert D. Neil Jr, his spouse, heirs or assigns, Threefold Defensive Training Inc, Threefold Defensive Training staff, the NRA, and the Land Owner including, but not limited to any and all injuries, damages or illnesses including but not limited to:

· hearing loss,

· blindness,

· abrasions,

· bruises/contusions

· lead poisoning,

· broken bones,

· gunshots,

· great blood loss,

· death

· permanent disability or impairment

· paralysis

that may be suffered by the Undersigned, which may, in any way whatsoever, arise out of, be related to or be connected with the Training; the premises (including any latent defect in the Premises); the Undersigned’s presence on or use of premises; or the Undersigned’s property (whether or not entrusted to NRA Instructor Robert D. Neil, Threefold Defensive Training Inc, Threefold Defensive Training Staff).

The Undersigned, furthermore hereby acknowledges and agrees that he/she has read, understands and will at all times abide by all Threefold Defensive Training Inc rules, procedures, and safety rules. The Undersigned agrees to abide by and follow any and all Range Officer instructions, whether communicated in writing, posted on the premises and/or communicated verbally. Any violation by the Undersigned will be considered cause for the removal of the Undersigned from any class at the discretion of the instructor or range safety officers without a refund.

By signing below Undersigned is accepting the risks set forth in the body of this waiver, and agrees to proceed with participating in the Training. Undersigned also agrees that by signing, Undersigned is accepting that "SmartWaiver" is acting as witness to this agreement. If any part of this agreement is found to be illegal or non-binding, then strike that portion, but the rest of the agreement will remain in full effect. This instrument binds the Undersigned and his/her executors, administrators, assignees or heirs and any minor for whom it is signed. If obviously under the age of 25, my age is listed.

· If a minor, under the age of 18 years, I understand a parent or legal guardian’s signature is required. This waiver is both personal and on behalf of any minor for whom it is executed.

Please select who will be participating...
AdultMinor
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First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
Select Gender
First Participant's Date of Birth*
Date of Birth
First Participant's Information
If your name appears differently on your Drivers License or State I.D. than what you entered above, please enter it here.
Please enter the date of the class you are interested in attending. You may choose from the Threefold website calendar, or contact us to arrange a date. (Your deposit may be moved to a different class in case of unavoidable reschedule.) *
Are you under indictment or information in any court for a felony, or any other crime for which the judge could imprison you for more than one year, or are you a current member of the military who has been charged with violation(s) of the Uniform Code of Military Justice and whose charge(s) have been referred to a general court-martial?*
No
Yes
Have you ever been convicted in any court, including a military court, of a felony, or any other crime for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation?*
No
Yes
Are you a fugitive from justice?*
No
Yes
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.*
No
Yes
Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution?*
No
Yes
Have you ever been discharged from the Armed Forces under dishonorable conditions?*
No
Yes
Are you subject to a court order, including a Military Protection Order issued by a military judge or magistrate, restraining you from harassing, stalking, or threatening your child or an intimate partner or child of such partner?*
No
Yes
Have you ever been convicted in any court of a misdemeanor crime of domestic violence, or are you or have you ever been a member of the military and been convicted of a crime that included, as an element, the use of force against a person as identified in the instructions?*
No
Yes
Have you ever renounced your United States citizenship?*
No
Yes
Are you an alien illegally or unlawfully in the United States?*
No
Yes
Are you an alien who has been admitted to the United States under a nonimmigrant visa?*
No
Yes

I certify that my answers above are true, correct, and complete.

I understand that a person who answers “yes” to any of the above questions is prohibited from receiving or possessing a firearm.

I also understand that making any false oral or written statement, or exhibiting any false or misrepresented identification with respect to this transaction, is a crime punishable as a felony under Federal law, and may also violate State and/or local law.

If you answered YES to one or more of questions above please contact Threefold Defensive Training via email with an explanation.  

Please enter the date below that you agree to certify your answers.

Click to customize date box label *
First 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, newsletter, and discounts by e-mail.
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Courses Available
Please choose the course in which you are participating at this time (We can always schedule you into another course we offer):*
3FDT CCW Course
AR Rifle Platform Essentials
CCW Skills Level 1
CCW Skills Level 2
CCW Skills Level 3
CPR/First Aid
FASTER Essentials
Force on Force
Intro to Handgun
NRA Basics of Pistol Shooting
NRA Basics of Rifle Shooting
NRA Basics of Shotgun Shooting
NRA CCW (Student)
NRA Personal Protection ITH
NRA Personal Protection OTH
NRA Range Safety Officer (RSO)
NRA Instructor Pistol Shooting course
NRA CCW Instructor course
NRA Instructor Rifle Shooting course
NRA Instructor Shotgun Shooting course
NRA PPITH/OTH Instructor
NRA Chief RSO (Instructor)
NRA Defensive Pistol
Pepper Spray Class
Personal Defense
Private Training
Refuse To Be A Victim
Security Training
Stop The Bleed
Youth Firearms Safety
Other
Are you currently a member of the NRA?*
No
Yes
If you are a current NRA member, please include your Member # and expiration date.
Are you currently a member of the USCCA?*
No
Yes
If you are a member of the USCCA, please enter your member number here:
As of today are you legally allowed to be in possession of a firearm? (If no, please ask to speak to the instructor immediately.)*
No
Yes
When we meet for class will you be under the influence of marijuana, alcohol, or prescription medication? (If yes, please ask to speak to the instructor immediately.)*
No
Yes
Photos and videos may be taken during this class. Do we have your permission to use photographs with your likeness on our website? (Extreme close up frontal facial angles and names will not be published without your prior approval.)*
No
Yes
Do you agree that the use of cameras during the class can be a safety hazard, and understand that only Threefold Staff will be able to take photographs or video without prior Staff consent. Photographs will be made available at no fee to the students after the class by request. *
Yes
No
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*
Middle Name
Last Name*
Relationship*
Phone*
Select Gender
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Information
If your name appears differently on your Drivers License or State I.D. than what you entered above, please enter it here.
Please enter the date of the class you are interested in attending. You may choose from the Threefold website calendar, or contact us to arrange a date. (Your deposit may be moved to a different class in case of unavoidable reschedule.) *
Are you under indictment or information in any court for a felony, or any other crime for which the judge could imprison you for more than one year, or are you a current member of the military who has been charged with violation(s) of the Uniform Code of Military Justice and whose charge(s) have been referred to a general court-martial?*
No
Yes
Have you ever been convicted in any court, including a military court, of a felony, or any other crime for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation?*
No
Yes
Are you a fugitive from justice?*
No
Yes
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.*
No
Yes
Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution?*
No
Yes
Have you ever been discharged from the Armed Forces under dishonorable conditions?*
No
Yes
Are you subject to a court order, including a Military Protection Order issued by a military judge or magistrate, restraining you from harassing, stalking, or threatening your child or an intimate partner or child of such partner?*
No
Yes
Have you ever been convicted in any court of a misdemeanor crime of domestic violence, or are you or have you ever been a member of the military and been convicted of a crime that included, as an element, the use of force against a person as identified in the instructions?*
No
Yes
Have you ever renounced your United States citizenship?*
No
Yes
Are you an alien illegally or unlawfully in the United States?*
No
Yes
Are you an alien who has been admitted to the United States under a nonimmigrant visa?*
No
Yes

I certify that my answers above are true, correct, and complete.

I understand that a person who answers “yes” to any of the above questions is prohibited from receiving or possessing a firearm.

I also understand that making any false oral or written statement, or exhibiting any false or misrepresented identification with respect to this transaction, is a crime punishable as a felony under Federal law, and may also violate State and/or local law.

If you answered YES to one or more of questions above please contact Threefold Defensive Training via email with an explanation.  

Please enter the date below that you agree to certify your answers.

Click to customize date box label *
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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