Loading...

TheRangeSTL.com
14803 Manchester Rd.
Ballwin, Missouri 63011
636.220.1300

The following agreement must be signed by the parent or legal guardian of anyone under the age of 18 years old before they may enter the shooting bays.

I acknowledge that the shooting sports can be dangerous. I recognize the importance of following the instructors’ and or coaches’ instructions regarding safety, practice techniques, range activities, classroom instruction, etc., and agree to obey such instructions. If between the ages of 10 -12, I will only be allowed to shoot .22 caliber firearms, unless prior consent is given by the Range Safety Officer. 

I understand and agree to obey the NRA Three Gun Safety Rules:

Rule #1: ALWAYS keep the gun pointed in a safe direction.

Rule #2: ALWAYS keep your finger off the trigger until ready to shoot.

Rule #3: ALWAYS keep the gun unloaded until ready to use.

I am the parent or legal guardian of Minor, and I have read the above warning and release and understand its terms. I understand that shooting and shooting sports can be dangerous and involve risk of injury or death. I have decided to allow him/her to participate in shooting at The Range St. Louis West and or Youth Firearms Sports Activities hosted by The Range St. Louis West which are offered to shooters under 21 years of age. If my child is between the ages of 10 -12, he/she  will only shoot .22 caliber firearms, unless prior consent is given by the Range Safety Officer. I certify as parent / guardian that the minor(s) I am representing are 10 years of age or older and understand that The Range St. Louis West minimum age requirement is 10 years of age.

In consideration of The Range St. Louis West, permitting my child to engage in all activities related to participating in shooting and shooting sports training and competitions, I hereby assume all the risks associated with shooting activities and agree to hold The Range St. Louis West, its employees, agents, representatives, coaches, instructors, and volunteers harmless from any liability, actions, causes of action, debts, claims or demands of any kind and nature whatsoever which may arise by or in connection with their participation in any activities related to shooting at The Range St. Louis West. The terms hereof shall serve as a release and assumption of risk for my heirs, estate, executor, administrator, assignees, and for all members of my family.

Today's Date: April 12, 2024


First Participant's Name

First Name*

Middle Name

Last Name*

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle 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.


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 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!