Loading...

RANGE USE AGREEMENT

RANGE 129 HAS A ZERO TOLERANCE POLICY FOR INDIVIDUALS UNDER THE INFLUENCE OF ALCOHOL OR ANY CONTROLLED SUBSTANCES INCLUDING MARIJUANA. IF YOU SMELL OF ANY SUBSTANCE, YOU WILL BE ASKED TO LEAVE IMMEDIATELY. 

PLEASE NOTE THAT ANY INDIVIDUAL WHO;

  1.  IS A CONVICTED FELON;

  2.  IS CURRENTLY ON PROBATION OR PAROLE;

  3.  IS CURRENTLY UNDER A TEMPORARY OR FINAL RESTRAINING ORDER DUE TO DOMESTIC VIOLENCE;

  4.  HAS BEEN ADJUDGED MENTALLY INCOMPETENT;

  5.  IS SUICIDAL, DEPRESSED OR RECEVING TREATMENT AND/OR TAKING MEDICATION FOR DEPRESSION;

WILL NOT BE PERMITTED TO HANDLE ANY FIREARMS OR BE ALLOWED INTO THE RANGE AREA.

 

RANGE 129 RESERVES THE RIGHT TO DENY SERVICE TO ANYONE.

 

ANY ACTS DEEMED INAPPROPRIATE BY A RANGE 129 TEAM MEMBER WILL RESULT IN IMMEDIATE EXPLUSION FROM THE FACILITY WITHOUT A REFUND.

 

I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE ABOVE STATED MATTERS AND AM ABLE TO CONTINUE ON WITH THE RANGE USE AGREEMENT.

 

April 26, 2024

 

Upon entering Range 129, I understand that I am entering a private shooting range at my own risk where I will encounter high levels of noise and the discharge of ammunition from firearms. By entering this property, it is at my own risk and I acknowledge the liabilities and dangers that exist in my use of any and all firearms and my participation in shooting activities.

 

First, I acknowledge and understand that shooting activities are inherently hazardous and involve both known and unanticipated risks which could result in damage or destruction of property and physical or emotional injury, including paralysis or death, of myself or of other persons and I assume the risks that could result in physical and/ or emotional injury, paralysis, death, or damage to myself, to property, or to third-parties. The risks include, but are not limited to; flying bullets, flying debris, noise, being shot by or shooting myself or others, partial or total loss of eyesight or hearing, inhalation or other harmful contact with lead or other contaminants and being struck by flying or falling objects. I understand that such risks cannot be eliminated without compromising the essential qualities of shooting activities. If a female patron is pregnant or suspects she may be, Range 129 encourages her to consult with her Physician prior to shooting.

 

Second, I understand that Range 129 reserves the right to eject from the premises any individual who violates any of the rules of Range 129 or otherwise acts in any unsafe manner as determined by Range 129.  Repeated from above, any acts deemed inappropriate by a Range 129 Team Member will result in immediate expulsion from the facility without a refund. The undersigned agrees to peaceably leave the premises of Range 129 if so ejected, after paying for all services and any damage that I may have caused to Range 129 property.

 

Third, in consideration of the acceptance of my participation , directly or as a spectator or observer, in any activity, class, competition, firing range rental, firearm rental, or other use of the facilities of Range 129, collectively hereinafter referred to as; "Activity", THE UNDERSIGNED AGREES TO ASSUME THE RISKS incidental to such participation and, on my own behalf and on behalf of my heirs, executors and administrators, I RELEASE, INDEMNIFY, DEFEND, HOLD HARMLESS, COVENANT NOT TO SUE AND FOREVER DISCHARGE Range 129 and related, affiliated and subsidiary companies, and the officers, directors, employees, volunteers, agents, representatives, insurers, successors, heirs and assigns of each, of and from fault, liabilities, costs, expenses,claims or demands for damages, causes of action, attachments of property, injury, death or financial compensation of any nature arising out of or in any way connected with my participation in any such Activity.

 

Fourth, I also Release, Indemnify, Defend, Hold Harmless and Forever Discharge Range 129 from all lawsuits arising out of, related to or connected with: the discharge of firearms; the course of instruction, the Range 129 range, buildings, land and premises, hereinafter referred to as the "premises", and my presence on or use of said premises. And, should any such claim, demand or lawsuit arise or be asserted in any way whatsoever related thereto, whether arising under the laws of the United States, the State of New Jersey, or under any theory or law or equity, I will Indemnify, Defend and Hold Harmless Range 129 from any and all costs, expenses, or liability including, but not limited to, the cost of any settlement or judgment made or rendered against Range 129, whether individually, jointly or in solidarity with the undersigned, together with all costs and other costs or expenses incurred in connection with any such claim, demand or lawsuit including attorney's fees.

 

Fifth, I acknowledge and understand that Range 129 makes no warranty as to the design, manufacture, maintenance, condition or fitness for any particular purpose of any range facilities or equipment, including, but not limited to; firearms, ammunition, eye/hearing protection and first-aid supplies. I agree to assume any and all responsibility and liability for any act or acts, even any negligent, reckless or criminal act or omission to act, of my guests at the range and for minors under my supervision. Also, I agree to supervise and be responsible for any minor in my care while on the property and I shall be personally responsible for my safety and the safety of minors under my supervision and for the safety of my guests.

 

Sixth, I waive for myself and my executors, administrators, assignees or heirs, any and all rights and claims for damages, losses, demands and any other actions whatsoever, which I may have or which may arise against Range 129, including but not limited to any and all injuries, damages or illnesses suffered by me or my property, which may, in any way whatsoever, arise out of, be related to or be connected with;

    1.  the course of instruction;

    2.  the premises, including any latent defense in the premises;

    3.  my presence on or use of said premises;

    4.  my property, whether or not entrusted to Range 129 and;

    5.  the discharge of firearms.

Range 129 shall not be liable for, and I hereby expressly Release, Indemnify, Defend and Hold Harmless Range 129 from any and all such claims on behalf of myself and my executors, administrators, assignees, or heirs.

 

Seventh, I acknowledge and understand that Range 129 has no duty to undertake first-aid or rescue operations or procedures in the event any such property damage or physical or emotional injury occurs. In entering into this Agreement, I hereby grant Range 129 a Limited Power of Attorney and authorization to obtain, at my cost, any and all emergency medical treatment, which may be needed by me as a result of participation in any Activity. For the purposes of this Agreement, emergency medical treatment means medical care or treatment necessitated by a sudden, unexpected situation demanding immediate medical attention . However, I Release, Indemnify, Defend, Hold Harmless, Covenant not to Sue, and Forever Discharge Range 129 of and from all liabilities, claims, actions, damages, costs or expenses of any nature arising out of or in any way connected with the exercise or the failure to exercise such Limited Power of Attorney and authorization, whether negligent or otherwise.

 

I expressly agree that this Agreement is intended to be as broad and inclusive as permitted by law, and that if any provision of this Agreement is held illegal, invalid or otherwise unenforceable, the enforceability of the remaining provisions shall not be impaired thereby, and such invalid part, term or provision shall not be deemed part of this Agreement. Further, I agree that any ambiguities in this Agreement shall not be construed in favor or against any party by virtue of that party having drafted the Agreement. No remedy conferred by any of the specific provisions of this Agreement is intended to be exclusive of any other remedy and each and every remedy shall be cumulative and shall be in addition to every other remedy now or hereafter existing at law or in equity or by statute or otherwise. The election of any one or more remedy hereunder shall not constitute any waiver of the right to pursue other available remedies.

 

I certify that I am entering into this Agreement on my own behalf. I expressly understand that the aforementioned Activity includes the discharge of firearms and the firing of live ammunition. I further certify that I have completely read the foregoing and I expressly agree.

 

 

Range 129 Range Safety Rules

 

If you observe a violation of these range rules, please bring it to the attention of any staff member and we will take immediate corrective action. It is our goal to provide you with a safe and fun range experience. Thank you from Staff and Management!

1. Keep your firearm unloaded and cased until you enter your shooting stall. Do not enter the store with a loaded firearm. UNCASE ALL FIREARMS IN THE SHOOTING STALLS ONLY! NO FIREARMS ARE ALLOWED BEHIND THE STALLS. All firearms must be in a securely fastened case, gun box, or securely tied package. Firearms will be inspected at the check-in counter at the request of Range 129’s staff. Any firearms or ammunition found to be unsafe or unserviceable will NOT be allowed onto the range.

2. When leaving the range area, ensure all firearms are unloaded and cased.

3. Eye and ear protection must be worn at all times while in the ranges, this includes entering the airlocks. I agree that prior to participating in or observing any shooting activities, I will inspect the Facilities, firearms and ammunition to be used and if I believe anything is unsafe, for any reason, I will advise a Range 129 Team Member and will leave the unsafe portion of the Facilities immediately.

4. Always keep firearms unloaded and your finger off the trigger until you are in the stall, on target and ready to shoot.

5. Dry firing is permitted from the shooting stall only.

6. If you have a jam or malfunction and cannot clear the issue yourself, keep firearm pointed down range and raise your non-shooting hand.  A  Range Safety Officer, hereinafter referred to as; "RSO", will be there to assist. Please follow the RSO’s instructions. DO NOT REMOVE THE FIREARM FROM THE SHOOTING STALL!

7. Do not hand a loaded firearm to another person. Make the firearm safe by engaging the safety, if applicable, removing the magazine, locking the slide to the rear, and visually and physically inspecting the chamber to be sure it’s safe and empty. Place the unloaded firearm on the shooting bench with the action open, safety on, muzzle pointed down range and the ejection port facing up.  The next person can then pick up a safe and empty weapon.

8. All Long guns must be bagged or cased.

9. Commands issued by an RSO must be followed immediately. When the command; “CEASE FIRE” is given: STOP SHOOTING immediately and REMOVE your finger from the trigger; keep the firearm POINTED DOWN RANGE, and WAIT for further instructions from an RSO.

10. Range 129 requires newly manufactured commercial ammunition at all times on Range 129. I will be totally responsible for using the correct ammunition for the firearms I am using. Black powder, steel core, tracers, armor piercing, incendiary, birdshot/ buckshot or other exotic ammunition is strictly prohibited. Slugs are the only ammunition permitted to be fired from a shotgun. No ammunition that contains; "Shot", will be allowed on the range. When using Range 129’s rental firearms, only ammunition purchased at Range 129 will be permitted.

11. Minimum age of use for our facility is 10 years old.  All shooters under the age of 18 must be accompanied by a parent/legal guardian at all times on the range.

12. Two people maximum per lane – other guests must remain in the retail area and can watch through the viewing windows. Only 1 shooter may fire at a time.

13. No cross-lane shooting. Shooting at anything other than your own target is prohibited and will subject you to immediate removal from the range.

14. No one is permitted across the firing line at any time. Request an RSO to retrieve any equipment that falls beyond the firing line.

15. Range 129 reserves the right to deny the use of targets on the range that may be deemed offensive or unsafe.

16. Use the appropriate size target, placed on the cardboard backing, to ensure that your shot strikes the backstop and not the floor, ceiling, or target carrier.

17. No uncontrolled fast or rapid firing allowed. Allow at least 1 second between shots. Any hazardous behavior will result in immediate dismissal from the premises.

18. Firing a shot that results in damage to any range equipment may result in a repair fee and/or immediate removal from the range. I acknowledge and fully understand that I and all others engaged in shooting, coaching, observing or training with firearms at Range 129 will be engages in activities that involve inherent risks of serious personal injury including disability or death and sever social and economic losses, which might result from my actions or inactions or the actions or inactions of others; such risks include but are not limited to:

    a.  My failure to abide by firearms safety rules or to properly handle or use firearms or ammunition;

    b.  The failure of others to abide by firearms safety rules or to properly handle or use firearms or ammunition;

    c.  The characteristics, including the design, manufacturing or other defects, of any firearm or ammunition being used by myself or others at Range 129.

19. Food, beverages, and tobacco are not allowed in the ranges. Smoking or vaping is strictly prohibited on Range 129 property.

20. Wearing or drawing from a holster is permitted on the 2 opposing end lanes for Law Enforcement Officers and those who have successfully passed our Basic Holster course.

21. Report all violations of range rules to and RSO or Range 129 team members.

22. Range 129 reserves the right to refuse services and membership to any individual who, in our judgment, would endanger the safety of our staff or patrons. Any unsafe conduct may result in immediate dismissal from the range without refund.

23. I understand that I may be under video surveillance, photographed or electronically recorded by some other means. I understand that I may be identifiable from such photographic, electronic or video reproductions. I further understand the releases may use such recordings or reproductions for advertising, promotions, education or any other reason the releases may deem appropriate.

24. Range 129's bullet traps are designed to handle handgun and rifle calibers under .50 caliber. If you are unsure if your firearm may be shot on the range, please ask a Team member for assistance.

25. Be sure your firearm is safe to operate and you know how to properly operate it. Please see an RSO if you have any questions.

26. Negligent, accidental, unintentional discharges, damages or injuries, no matter how minor, must be reported to an RSO immediately.

27. All shooters must view the safety video or in person instruction provided at Range 129.

28. Proper attire must be worn to shoot at Range 129. Open toes shoes, sandals, flip flops or high heels are not suggested rather you should be in comfortable shoes. This dress code is in place for your safety and to prevent hot brass making contact with your skin. Range 129 reserves the right to refuse anyone to shoot at our facility for dress code.

29. Range 129 staff has the final authority.

 

I have read, agree and understand the Range 129 Range Rules and this liability waiver and I was given the opportunity to ask for clarification of any of the rules before signing this Agreement.

April 26, 2024

First Customer's Name

First Name*

Middle Name

Last Name*

Phone*
First Customer's Date of Birth*
First Customer's Questionnaire
Are you under the influence of alcohol, chemical substances or controlled substances?*
No
Yes

RANGE 129 HAS A ZERO TOLERANCE POLICY FOR INDIVIDUALS UNDER THE INFLUENCE OF ALCOHOL OR ANY CONTROLLED SUBSTANCES INCLUDING MARIJUANA.  IF YOU SMELL OF ANY SUBSTANCE, YOU WILL BE ASKED TO LEAVE IMMEDIATELY. 

Are you suicidal or depressed or are you receiving treatment or taking medication for depression?*
No
Yes
Have you been adjudged or deemed mentally incompetent*
No
Yes
Have you been issued a restraining order due to committing acts of domestic violence?*
No
Yes
Are you currently on probation?*
No
Yes
Are you a convicted felon*
No
Yes

Your Background with Firearms

Have you ever shot or handled a handgun, rifle or shotgun before?*
No
Yes
If so, which one(s)?
Handgun
Rifle
Shotgun
Please select the answer that best describes your shooting experience;*
New Shooter
1-2 Times a Year
1-2 Times a Month
1-2 Times a Week

All New Shooters will be given an instructional on the firearm they will be using by a Range 129 Team Member, prior to entering the ranges.

If you are not a New Shooter, would you like any additional instruction on the firearm you will be using today?*
No
Yes
First Customer's Signature*
Second Customer's Name

First Name*

Middle Name

Last Name*

Phone*
Second Customer's Date of Birth*
Second Customer's Questionnaire
Are you under the influence of alcohol, chemical substances or controlled substances?*
No
Yes

RANGE 129 HAS A ZERO TOLERANCE POLICY FOR INDIVIDUALS UNDER THE INFLUENCE OF ALCOHOL OR ANY CONTROLLED SUBSTANCES INCLUDING MARIJUANA.  IF YOU SMELL OF ANY SUBSTANCE, YOU WILL BE ASKED TO LEAVE IMMEDIATELY. 

Are you suicidal or depressed or are you receiving treatment or taking medication for depression?*
No
Yes
Have you been adjudged or deemed mentally incompetent*
No
Yes
Have you been issued a restraining order due to committing acts of domestic violence?*
No
Yes
Are you currently on probation?*
No
Yes
Are you a convicted felon*
No
Yes

Your Background with Firearms

Have you ever shot or handled a handgun, rifle or shotgun before?*
No
Yes
If so, which one(s)?
Handgun
Rifle
Shotgun
Please select the answer that best describes your shooting experience;*
New Shooter
1-2 Times a Year
1-2 Times a Month
1-2 Times a Week

All New Shooters will be given an instructional on the firearm they will be using by a Range 129 Team Member, prior to entering the ranges.

If you are not a New Shooter, would you like any additional instruction on the firearm you will be using today?*
No
Yes
Third Customer's Name

First Name*

Middle Name

Last Name*

Phone*
Third Customer's Date of Birth*
Third Customer's Questionnaire
Are you under the influence of alcohol, chemical substances or controlled substances?*
No
Yes

RANGE 129 HAS A ZERO TOLERANCE POLICY FOR INDIVIDUALS UNDER THE INFLUENCE OF ALCOHOL OR ANY CONTROLLED SUBSTANCES INCLUDING MARIJUANA.  IF YOU SMELL OF ANY SUBSTANCE, YOU WILL BE ASKED TO LEAVE IMMEDIATELY. 

Are you suicidal or depressed or are you receiving treatment or taking medication for depression?*
No
Yes
Have you been adjudged or deemed mentally incompetent*
No
Yes
Have you been issued a restraining order due to committing acts of domestic violence?*
No
Yes
Are you currently on probation?*
No
Yes
Are you a convicted felon*
No
Yes

Your Background with Firearms

Have you ever shot or handled a handgun, rifle or shotgun before?*
No
Yes
If so, which one(s)?
Handgun
Rifle
Shotgun
Please select the answer that best describes your shooting experience;*
New Shooter
1-2 Times a Year
1-2 Times a Month
1-2 Times a Week

All New Shooters will be given an instructional on the firearm they will be using by a Range 129 Team Member, prior to entering the ranges.

If you are not a New Shooter, would you like any additional instruction on the firearm you will be using today?*
No
Yes
Fourth Customer's Name

First Name*

Middle Name

Last Name*

Phone*
Fourth Customer's Date of Birth*
Fourth Customer's Questionnaire
Are you under the influence of alcohol, chemical substances or controlled substances?*
No
Yes

RANGE 129 HAS A ZERO TOLERANCE POLICY FOR INDIVIDUALS UNDER THE INFLUENCE OF ALCOHOL OR ANY CONTROLLED SUBSTANCES INCLUDING MARIJUANA.  IF YOU SMELL OF ANY SUBSTANCE, YOU WILL BE ASKED TO LEAVE IMMEDIATELY. 

Are you suicidal or depressed or are you receiving treatment or taking medication for depression?*
No
Yes
Have you been adjudged or deemed mentally incompetent*
No
Yes
Have you been issued a restraining order due to committing acts of domestic violence?*
No
Yes
Are you currently on probation?*
No
Yes
Are you a convicted felon*
No
Yes

Your Background with Firearms

Have you ever shot or handled a handgun, rifle or shotgun before?*
No
Yes
If so, which one(s)?
Handgun
Rifle
Shotgun
Please select the answer that best describes your shooting experience;*
New Shooter
1-2 Times a Year
1-2 Times a Month
1-2 Times a Week

All New Shooters will be given an instructional on the firearm they will be using by a Range 129 Team Member, prior to entering the ranges.

If you are not a New Shooter, would you like any additional instruction on the firearm you will be using today?*
No
Yes
Fifth Customer's Name

First Name*

Middle Name

Last Name*

Phone*
Fifth Customer's Date of Birth*
Fifth Customer's Questionnaire
Are you under the influence of alcohol, chemical substances or controlled substances?*
No
Yes

RANGE 129 HAS A ZERO TOLERANCE POLICY FOR INDIVIDUALS UNDER THE INFLUENCE OF ALCOHOL OR ANY CONTROLLED SUBSTANCES INCLUDING MARIJUANA.  IF YOU SMELL OF ANY SUBSTANCE, YOU WILL BE ASKED TO LEAVE IMMEDIATELY. 

Are you suicidal or depressed or are you receiving treatment or taking medication for depression?*
No
Yes
Have you been adjudged or deemed mentally incompetent*
No
Yes
Have you been issued a restraining order due to committing acts of domestic violence?*
No
Yes
Are you currently on probation?*
No
Yes
Are you a convicted felon*
No
Yes

Your Background with Firearms

Have you ever shot or handled a handgun, rifle or shotgun before?*
No
Yes
If so, which one(s)?
Handgun
Rifle
Shotgun
Please select the answer that best describes your shooting experience;*
New Shooter
1-2 Times a Year
1-2 Times a Month
1-2 Times a Week

All New Shooters will be given an instructional on the firearm they will be using by a Range 129 Team Member, prior to entering the ranges.

If you are not a New Shooter, would you like any additional instruction on the firearm you will be using today?*
No
Yes
Sixth Customer's Name

First Name*

Middle Name

Last Name*

Phone*
Sixth Customer's Date of Birth*
Sixth Customer's Questionnaire
Are you under the influence of alcohol, chemical substances or controlled substances?*
No
Yes

RANGE 129 HAS A ZERO TOLERANCE POLICY FOR INDIVIDUALS UNDER THE INFLUENCE OF ALCOHOL OR ANY CONTROLLED SUBSTANCES INCLUDING MARIJUANA.  IF YOU SMELL OF ANY SUBSTANCE, YOU WILL BE ASKED TO LEAVE IMMEDIATELY. 

Are you suicidal or depressed or are you receiving treatment or taking medication for depression?*
No
Yes
Have you been adjudged or deemed mentally incompetent*
No
Yes
Have you been issued a restraining order due to committing acts of domestic violence?*
No
Yes
Are you currently on probation?*
No
Yes
Are you a convicted felon*
No
Yes

Your Background with Firearms

Have you ever shot or handled a handgun, rifle or shotgun before?*
No
Yes
If so, which one(s)?
Handgun
Rifle
Shotgun
Please select the answer that best describes your shooting experience;*
New Shooter
1-2 Times a Year
1-2 Times a Month
1-2 Times a Week

All New Shooters will be given an instructional on the firearm they will be using by a Range 129 Team Member, prior to entering the ranges.

If you are not a New Shooter, would you like any additional instruction on the firearm you will be using today?*
No
Yes
Seventh Customer's Name

First Name*

Middle Name

Last Name*

Phone*
Seventh Customer's Date of Birth*
Seventh Customer's Questionnaire
Are you under the influence of alcohol, chemical substances or controlled substances?*
No
Yes

RANGE 129 HAS A ZERO TOLERANCE POLICY FOR INDIVIDUALS UNDER THE INFLUENCE OF ALCOHOL OR ANY CONTROLLED SUBSTANCES INCLUDING MARIJUANA.  IF YOU SMELL OF ANY SUBSTANCE, YOU WILL BE ASKED TO LEAVE IMMEDIATELY. 

Are you suicidal or depressed or are you receiving treatment or taking medication for depression?*
No
Yes
Have you been adjudged or deemed mentally incompetent*
No
Yes
Have you been issued a restraining order due to committing acts of domestic violence?*
No
Yes
Are you currently on probation?*
No
Yes
Are you a convicted felon*
No
Yes

Your Background with Firearms

Have you ever shot or handled a handgun, rifle or shotgun before?*
No
Yes
If so, which one(s)?
Handgun
Rifle
Shotgun
Please select the answer that best describes your shooting experience;*
New Shooter
1-2 Times a Year
1-2 Times a Month
1-2 Times a Week

All New Shooters will be given an instructional on the firearm they will be using by a Range 129 Team Member, prior to entering the ranges.

If you are not a New Shooter, would you like any additional instruction on the firearm you will be using today?*
No
Yes
Eighth Customer's Name

First Name*

Middle Name

Last Name*

Phone*
Eighth Customer's Date of Birth*
Eighth Customer's Questionnaire
Are you under the influence of alcohol, chemical substances or controlled substances?*
No
Yes

RANGE 129 HAS A ZERO TOLERANCE POLICY FOR INDIVIDUALS UNDER THE INFLUENCE OF ALCOHOL OR ANY CONTROLLED SUBSTANCES INCLUDING MARIJUANA.  IF YOU SMELL OF ANY SUBSTANCE, YOU WILL BE ASKED TO LEAVE IMMEDIATELY. 

Are you suicidal or depressed or are you receiving treatment or taking medication for depression?*
No
Yes
Have you been adjudged or deemed mentally incompetent*
No
Yes
Have you been issued a restraining order due to committing acts of domestic violence?*
No
Yes
Are you currently on probation?*
No
Yes
Are you a convicted felon*
No
Yes

Your Background with Firearms

Have you ever shot or handled a handgun, rifle or shotgun before?*
No
Yes
If so, which one(s)?
Handgun
Rifle
Shotgun
Please select the answer that best describes your shooting experience;*
New Shooter
1-2 Times a Year
1-2 Times a Month
1-2 Times a Week

All New Shooters will be given an instructional on the firearm they will be using by a Range 129 Team Member, prior to entering the ranges.

If you are not a New Shooter, would you like any additional instruction on the firearm you will be using today?*
No
Yes
Ninth Customer's Name

First Name*

Middle Name

Last Name*

Phone*
Ninth Customer's Date of Birth*
Ninth Customer's Questionnaire
Are you under the influence of alcohol, chemical substances or controlled substances?*
No
Yes

RANGE 129 HAS A ZERO TOLERANCE POLICY FOR INDIVIDUALS UNDER THE INFLUENCE OF ALCOHOL OR ANY CONTROLLED SUBSTANCES INCLUDING MARIJUANA.  IF YOU SMELL OF ANY SUBSTANCE, YOU WILL BE ASKED TO LEAVE IMMEDIATELY. 

Are you suicidal or depressed or are you receiving treatment or taking medication for depression?*
No
Yes
Have you been adjudged or deemed mentally incompetent*
No
Yes
Have you been issued a restraining order due to committing acts of domestic violence?*
No
Yes
Are you currently on probation?*
No
Yes
Are you a convicted felon*
No
Yes

Your Background with Firearms

Have you ever shot or handled a handgun, rifle or shotgun before?*
No
Yes
If so, which one(s)?
Handgun
Rifle
Shotgun
Please select the answer that best describes your shooting experience;*
New Shooter
1-2 Times a Year
1-2 Times a Month
1-2 Times a Week

All New Shooters will be given an instructional on the firearm they will be using by a Range 129 Team Member, prior to entering the ranges.

If you are not a New Shooter, would you like any additional instruction on the firearm you will be using today?*
No
Yes
Tenth Customer's Name

First Name*

Middle Name

Last Name*

Phone*
Tenth Customer's Date of Birth*
Tenth Customer's Questionnaire
Are you under the influence of alcohol, chemical substances or controlled substances?*
No
Yes

RANGE 129 HAS A ZERO TOLERANCE POLICY FOR INDIVIDUALS UNDER THE INFLUENCE OF ALCOHOL OR ANY CONTROLLED SUBSTANCES INCLUDING MARIJUANA.  IF YOU SMELL OF ANY SUBSTANCE, YOU WILL BE ASKED TO LEAVE IMMEDIATELY. 

Are you suicidal or depressed or are you receiving treatment or taking medication for depression?*
No
Yes
Have you been adjudged or deemed mentally incompetent*
No
Yes
Have you been issued a restraining order due to committing acts of domestic violence?*
No
Yes
Are you currently on probation?*
No
Yes
Are you a convicted felon*
No
Yes

Your Background with Firearms

Have you ever shot or handled a handgun, rifle or shotgun before?*
No
Yes
If so, which one(s)?
Handgun
Rifle
Shotgun
Please select the answer that best describes your shooting experience;*
New Shooter
1-2 Times a Year
1-2 Times a Month
1-2 Times a Week

All New Shooters will be given an instructional on the firearm they will be using by a Range 129 Team Member, prior to entering the ranges.

If you are not a New Shooter, would you like any additional instruction on the firearm you will be using today?*
No
Yes
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
A signed copy of this waiver will be sent to the email address you provide.
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*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Questionnaire
Are you under the influence of alcohol, chemical substances or controlled substances?*
No
Yes

RANGE 129 HAS A ZERO TOLERANCE POLICY FOR INDIVIDUALS UNDER THE INFLUENCE OF ALCOHOL OR ANY CONTROLLED SUBSTANCES INCLUDING MARIJUANA.  IF YOU SMELL OF ANY SUBSTANCE, YOU WILL BE ASKED TO LEAVE IMMEDIATELY. 

Are you suicidal or depressed or are you receiving treatment or taking medication for depression?*
No
Yes
Have you been adjudged or deemed mentally incompetent*
No
Yes
Have you been issued a restraining order due to committing acts of domestic violence?*
No
Yes
Are you currently on probation?*
No
Yes
Are you a convicted felon*
No
Yes

Your Background with Firearms

Have you ever shot or handled a handgun, rifle or shotgun before?*
No
Yes
If so, which one(s)?
Handgun
Rifle
Shotgun
Please select the answer that best describes your shooting experience;*
New Shooter
1-2 Times a Year
1-2 Times a Month
1-2 Times a Week

All New Shooters will be given an instructional on the firearm they will be using by a Range 129 Team Member, prior to entering the ranges.

If you are not a New Shooter, would you like any additional instruction on the firearm you will be using today?*
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!