Loading...

FOX VALLEY SHOOTING CLUB, LLC
WAIVER RELEASE AND INDEMNIFICATION AGREEMENT
MINORS’ WAIVER

I am signing this agreement as a parent or guardian of one or more children under the age of 18, so that the child(ren) may be able to enter the facilities or make use thereof.

hereinafter referred to as "minor(s).”

On behalf of the minor(s) who is/are identified above, as to whom I am the parent or legal guardian, generally and specifically, I hereby agree to allow the minor(s) to use the facilities and to participate in other activities of the Fox Valley Shooting Club. LLC d /b/a Fox Valley Shooting Range (hereinafter collectively referred to as ·'FVSC) and KMA Range Properties, LLC (hereinafter referred to as " KMA"), and on behalf of the minor(s):

(Participant must read and initial each paragraph).

1. ASSUMPTION OF RISK. I hereby acknowledge and fully understand the inherent risks, dangers and hazards associated with the use of a firearms or shooting range. firearm instruction. the discharge of firearms.  and the use of live ammunition. including, but not limited to the risk of physical injury. disfigurement. disability. emotional injury, or death and risk of loss of use or damage to my personal property. I further acknowledge and understand that injury or loss may result from: airborne materials and objects: the use of equipment. Materials or facilities: lead dust inhalation: noise: the acts or omissions of others: the unavailability of immediate and/or adequate emergency medical care: and, other unknown or unexpected risks. I hereby knowingly and voluntarily assume each of these risks, dangers and hazards. and all other risks. dangers and hazards. whether known or unknown.  that could arise out of, or occur during my presence on the FVSC and KMS premises, on behalf of the minor(s).

2. RELEASE AND INDEMNIFICATION. I on behalf of the minor(s), myself. their heirs. executors. administrators, representatives. successors and assigns. hereby forever release and discharge FVSC and KMA.  its members. owners. employees. gunsmiths. range safety officers. officers. directors, club members. instructors. guests, volunteers, agents and affiliates from any and all claims. demands. damages. expenses. causes of action, attachments of property, attorney fees, court costs or liability of any kind whatsoever that the minor(s). I. their heirs. executor. administrator, representatives, successors and/or assignees may have for property damage, personal injury. death resulting from my entering the premises. using the facilities or equipment. engaging in shooting. observing others shoot and/or any other activities at the FVSC facilities even if such claims, demands, damages. expenses. attachments of property, attorney fees. court costs a liability result from any acts of FVSC and/or KMA. even any negligent act or omission to act. including negligent or omitted first aid or rescue operations. 

I further agree to indemnify, defend and hold harmless FVSC and KMA from any and all claims. demands, damages, expenses. causes of action, attorneys fees court costs or liability of any kind that any person or entity may have for property damage, personal injury or death resulting from my entering the premises, using the facilities or equipment, engaging in shooting, observing others shoot and/or any other  activities at  the  FVSC  facilities  to the  extent that such claims, demands, damages. expenses. ca us es of action. attachments of property, attorney fees. Court costs or liability result whole or partially from any act or acts. even any negligent acts or omission to act, including any negligent or omitted first aid or rescue operations. 

3.  MEDICAL CERTIFICATION. I certify that the minor(s) have no medical condition or physical conditions that could in any way compromise my safety or the safety of others during my use of the range or participation in any activities or events at the FVSC facilities. 

4. LAWFUL POSSESSION. l hereby affirm that the minor(s) can lawfully possess a firearm in the State of Illinois and that any and all identification cards and permits provided to FVSC are validly issued and true and correct. 

5. RULES AND REGULATIONS. I have read, understood and agree to abide by all of the Range Operation and Safety rules of FVSC. I further agree to ab ide by any verbal instruction and /or safety rules issued by any FVSC instructor. staff member or range safety officer. 

6. INTERPRETATION AND SEVERABILITY. I further acknowledge that this contract shall be interpreted and enforced under the laws of the State of Illinois and agree that if any provision contained herein is held to be invalid, void or otherwise unenforceable, the remaining provisions of the agreement shall continue and remain in full force and effect. 

7. I have fully and carefully read this Waiver and Release and the Range Operation and Safety rules and understand their contents and that I am signing without inducement or any other cons ide ration. I AM AWARE THAT THIS IS A RELEASE FROM LIABILITY AND INDEMNIFICATION AGREEMENT AND THAT BY SIGNING THIS AGREEMENT I AM AGREEING NOT TO SUE FOX VALLEY SHOOTING CLUB, LLC D/B/A FOX VALLEY SHOOTING RANGE OR KMA RANGE PROPERTIES, LLC AND RELEASING AND HOLDING THEM HARMLESS OF ANY AND ALL LIABILITY. 

8. I hereby agree to be financially responsible for and to reimburse FVSC and KMA for any damage. I, the minor(s). my family members or my guests may cause to the premises range or equipment. I consent to being video recorded while on the premises and to removal from the range and/or termination of my membership in FVSC for violation of the range operation and safety rules. 

Date: September 30, 2020

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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*

Last Name*
Parent or Guardian's Date of Birth*
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!