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Wyoming Gun Company, Inc.

Release and Indemnity Agreement

All those who wish to use this facility- whether shooting a personal firearm, or shooting a rental firearm- must fill out this form in its entirety.  All information provided will be kept confidential, in case of an incident it could be given to our attorney, insurance company &/or law enforcement.  This waiver is strictly for use by Wyoming Gun Company, Inc.

Lawful Possession of Firearm and Ammunition: I, affirm I can lawfully possess firearms and ammunition under State and Federal laws.  Wyoming Gun Company must abide by local, state and federal laws. All persons using the facility must attest to the following:  I am legally allowed to possess a firearm in the United States.  I am not currently the subject of a criminal or civil restraining order.  I have never been convicted of a felony as an adult or juvenile.  I am not a fugitive from justice.  I am not an unlawful user of, or addicted to any controlled substance.  I have never been adjudicated in a court of law, as incompetent to manage my own affairs.  I have never been discharged from the United States armed forces under dishonorable conditions.  I am a citizen of or legally in the United States.

Assumption of Risk: I, hereby release Wyoming Gun Company, its member entities, owners, employees, gunsmiths, officers, directors, club members, volunteers, instructors, guests, agents and affiliates from all liability for personal injury or property damage through use, in any way, of the facility, its equipment, its firearms, or my own firearm.  I agree to indemnify the entity from responsibility for any claims or demands arising out of such use.  I agree to accept and assume any and all risks existing at Wyoming Gun Company and its operations at 580 Landmark Dr., Casper, WY 82609.  I acknowledge and understand that shooting activities are hazardous and involve risks both known and unanticipated.  I agree to assume all responsibility of these risks, which could result in damage to property and serious physical or emotional injury, including paralysis or death, to others or myself.  Possible known and unknown injuries may include, but are not limited to: being shot or injured in any manner by myself or others, shooting others, partial or total loss of eyesight or hearing, burns, amputation, inhalation or other harmful contact with lead or contaminants, being struck by flying of falling debris or projectiles, disability, and death.  I agree to assume all lability for any act, acts, or omission to act, even any negligent, reckless, or criminal act by any other or myself.

Release and Indemnification: I agree that myself and my heirs, guardians, representatives, successors, that myself, and assigns release and forever discharge and agree not to sue the Company officers, directors, attorneys, gunsmiths, agents, employees, contractors, volunteers, and guests.  I release and discharge these same parties for any and all claims, demands, damages, expenses, causes of action, attachments of property, or liability of any kind whatsoever that I may have for property damage, personal injury, or death resulting from my entering the premises, using the facilities or equipment, or engaging in or observing shooting and other activities at Wyoming Gun Company of Casper Wyoming and its operations, unless the injury or claim is solely a result of any negligent, reckless, or criminal act by the company.

Further, I agree to indemnify, defend, and hold harmless the Company, for any and all claims, damages, demands, causes of action, expenses, attachments of property, 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 any facilities or equipment, or engaging in or observing shooting and other activities at Wyoming Gun Company of Casper Wyoming and its operations, to the extent that such claims, damages, demands, causes of action, expenses, attachments of property, attorneys’ fees, court costs, or liability result partially or wholly from any negligent act of participant, or any act that would subject participant to strict liability. 

Medical Certification: I certify that I have no medical or physical conditions that could compromise my safety and the safety of others in any activities at Wyoming Gun Company.  I certify that I have adequate insurance to cover any injury or damage I may cause or suffer, or else I agree to personally bear the costs of such injury or damage. 

Other Rules: I agree to abide by all written, video, and verbal safety rules issued by Wyoming Gun Company instructors, staff, or Range Safety Officers. 

Range and Safety Rules:  I acknowledge that I have read, understand, and agree to abide by the Range and Safety Rules provided by Wyoming Gun Company. 

I have fully and carefully read this Waiver, Release and Indemnity Agreement and understand its contents.  I am aware that this is a release from liability and indemnification agreement and a contract between the Wyoming Gun Company and myself and that it imposes limitations to my legal rights.  I sign it of my own free will.  I certify that I will not operate any firearms or equipment with which I am not completely familiar.

I also consent to be financially responsible for and reimburse Wyoming Gun Company for any shooting that causes damage to the range or equipment.  I acknowledge that my shooting activities are recorded by a video camera for this purpose.  I consent to any repair or replacement for actual damages of up to $100,000.00, and/or removal from the range, and/or termination of my membership or disbarment from Wyoming Gun Company, Inc.

Range and Safety Rules

  1. Act responsibly and with respect at all times.
  2. If you observe any unsafe behavior or condition by anyone, report it to a Range Safety Officer immediately.
  3. All people on the range must observe the 4 basic firearm safety rules:
    a. Treat every firearm as if it were loaded
    b. Never point your firearm at anything you are not prepared to destroy
    c. Keep your finger off the trigger and out of the trigger well until you are on target and ready to fire
    d. Know your target and what is beyond
  4. All first-time members, guests and other Wyoming Gun Company users must demonstrate proper knowledge of firearm operation and safety, or they must participate in the WGC orientation.
  5. No one is allowed in front of the firing line at any time.
  6. Shooters may collect their brass from behind the firing line only.
  7. Eye and Ear protection is mandatory for anyone entering the range.
  8. Firearms brought onto the property must be unloaded and in a secure case or range bag prior to entering the facility.  Firearms may be uncased in the shooting stall only.
  9. Children under the age of 10 are not permitted to shoot on the range.
  10. Individuals under the age of 18 must be accompanied by a parent or legal guardian who will remain by their side at all times.
  11. Upon the command “CEASE FIRE”, stop all shooting immediately, put down your firearm and back away from the firing line.  Do NOT re-approach the firing line or pick up your firearm until the “All Clear” signal is given.
  12. For any firearm or ammunition problem, (such as a squib or hang fire) keep the gun pointed down range, do not set the gun down, remain in your booth, signal a Range Safety Officer for assistance by raising your non-shooting hand.
  13. Use only the correct ammunition for your firearm.  Wyoming Gun Company does NOT permit the following:
    a. STEEL CORE, STEEL SHOT, TRACER or ARMOR PIERCING ammunition
    b. MUZZLE-LOADERS or Black Powder
    c. Shot shells with multiple projectiles
  14. Firearms may be uncased or removed from the holster at the firing line.  Load and unload all weapons at the bench in the shooting booth.  No uncased firearms are permitted behind the shooting booth area.
  15. No one will be permitted on the range if they are under the influence of alcohol, drugs, or any other intoxicating substances.
  16. It is your responsibility to know and understand how to operate your firearm safely.  You must ensure that your firearm is in good working order before entering the range.
  17. Drawing from the holster is prohibited, unless you have prior approval.
  18. Any person seen intentionally shooting at anything other than their assigned target will be asked to leave.
  19. No food, drink, gum or any tobacco product is permitted inside the range.  Always remember to wash your hands after you leave the range and prior to eating.
  20. No outside paid instructors are permitted to instruct at Wyoming Gun Company.  All paid instruction will be provided by WGC certified instructors.
  21. Wyoming Gun Company complies with State and Federal Laws.  All shooters must be US Citizens or permanent resident with accompanying driver’s license or green card.

***It is strongly recommended that pregnant women do not use the indoor range due to the noise levels and how it can affect the hearing development of an unborn child***

Wyoming Gun Company’s rules and procedures are for the safety and comfort of its members, guests and surrounding community.  Violations of these rules will be evaluated and may result in termination of memberships and or immediate removal from the facility.  Safety is the primary goal at Wyoming Gun Company.  We want everyone to be able to enjoy shooting in a safe and fun environment.  We reserve the right to eject or refuse service to anyone who inappropriately handles a firearm or would potentially endanger the safety of our patrons or staff.

I acknowledge that I have read, understand, and agree to abide by the Range and Safety rules listed above.

**Wyoming Gun Company reserves the right to add, remove or alter these rules at any time** 11/07/18

Today's Date: October 20, 2019

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

FIREARMS EXPERIENCE & RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, whether using their own firearm or a Wyoming Gun Company rental firearm MUST completely fill out this form.  All information supplied will be kept strictly confidential, not distributed or made available to others for any purpose and is for the sole use by Wyoming Gun Company to properly identify the user and document their previous firearms experience.  This is being done to ensure the safety of all range users. This form will be completed one time but will be maintained as a matter of record of liability waiver for all subsequent visits.

FILLED OUT ON FIRST VISIT ONLY

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*
Have you ever been adjudicated as mentally defective, been committed to a mental institution, or have a history of mental illness?*
No
Yes
Have you ever been convicted of a FELONY or otherwise prohibited from handling or possessing firearms?*
No
Yes
Are you an unlawful user, or addicted to, marijuana, or any Depressant, stimulant, or narcotic drug, or any other controlled substance?*
No
Yes

Applicant, for itself and its executors and assigns, releases Wyoming Gun Company, Inc. from any and all liability for personal injury or property damage arising out of the use of the equipment and /or facilities of Wyoming Gun Company, Inc. and agrees to hold Wyoming Gun Company, Inc. free, clear, and harmless for and indemnify Wyoming Gun Company, Inc. from responsibility for any and all claims and demands for personal injury or property damage arising out of such use.

I agree to be held financially responsible for any willful or accidental act of destruction to the range or range equipment, beyond normal wear and tear. This includes shooting baffles.

First Participant's Signature*
Second Participant's Name

First Name*

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

FIREARMS EXPERIENCE & RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, whether using their own firearm or a Wyoming Gun Company rental firearm MUST completely fill out this form.  All information supplied will be kept strictly confidential, not distributed or made available to others for any purpose and is for the sole use by Wyoming Gun Company to properly identify the user and document their previous firearms experience.  This is being done to ensure the safety of all range users. This form will be completed one time but will be maintained as a matter of record of liability waiver for all subsequent visits.

FILLED OUT ON FIRST VISIT ONLY

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*
Have you ever been adjudicated as mentally defective, been committed to a mental institution, or have a history of mental illness?*
No
Yes
Have you ever been convicted of a FELONY or otherwise prohibited from handling or possessing firearms?*
No
Yes
Are you an unlawful user, or addicted to, marijuana, or any Depressant, stimulant, or narcotic drug, or any other controlled substance?*
No
Yes

Applicant, for itself and its executors and assigns, releases Wyoming Gun Company, Inc. from any and all liability for personal injury or property damage arising out of the use of the equipment and /or facilities of Wyoming Gun Company, Inc. and agrees to hold Wyoming Gun Company, Inc. free, clear, and harmless for and indemnify Wyoming Gun Company, Inc. from responsibility for any and all claims and demands for personal injury or property damage arising out of such use.

I agree to be held financially responsible for any willful or accidental act of destruction to the range or range equipment, beyond normal wear and tear. This includes shooting baffles.

Third Participant's Name

First Name*

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

FIREARMS EXPERIENCE & RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, whether using their own firearm or a Wyoming Gun Company rental firearm MUST completely fill out this form.  All information supplied will be kept strictly confidential, not distributed or made available to others for any purpose and is for the sole use by Wyoming Gun Company to properly identify the user and document their previous firearms experience.  This is being done to ensure the safety of all range users. This form will be completed one time but will be maintained as a matter of record of liability waiver for all subsequent visits.

FILLED OUT ON FIRST VISIT ONLY

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*
Have you ever been adjudicated as mentally defective, been committed to a mental institution, or have a history of mental illness?*
No
Yes
Have you ever been convicted of a FELONY or otherwise prohibited from handling or possessing firearms?*
No
Yes
Are you an unlawful user, or addicted to, marijuana, or any Depressant, stimulant, or narcotic drug, or any other controlled substance?*
No
Yes

Applicant, for itself and its executors and assigns, releases Wyoming Gun Company, Inc. from any and all liability for personal injury or property damage arising out of the use of the equipment and /or facilities of Wyoming Gun Company, Inc. and agrees to hold Wyoming Gun Company, Inc. free, clear, and harmless for and indemnify Wyoming Gun Company, Inc. from responsibility for any and all claims and demands for personal injury or property damage arising out of such use.

I agree to be held financially responsible for any willful or accidental act of destruction to the range or range equipment, beyond normal wear and tear. This includes shooting baffles.

Fourth Participant's Name

First Name*

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

FIREARMS EXPERIENCE & RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, whether using their own firearm or a Wyoming Gun Company rental firearm MUST completely fill out this form.  All information supplied will be kept strictly confidential, not distributed or made available to others for any purpose and is for the sole use by Wyoming Gun Company to properly identify the user and document their previous firearms experience.  This is being done to ensure the safety of all range users. This form will be completed one time but will be maintained as a matter of record of liability waiver for all subsequent visits.

FILLED OUT ON FIRST VISIT ONLY

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*
Have you ever been adjudicated as mentally defective, been committed to a mental institution, or have a history of mental illness?*
No
Yes
Have you ever been convicted of a FELONY or otherwise prohibited from handling or possessing firearms?*
No
Yes
Are you an unlawful user, or addicted to, marijuana, or any Depressant, stimulant, or narcotic drug, or any other controlled substance?*
No
Yes

Applicant, for itself and its executors and assigns, releases Wyoming Gun Company, Inc. from any and all liability for personal injury or property damage arising out of the use of the equipment and /or facilities of Wyoming Gun Company, Inc. and agrees to hold Wyoming Gun Company, Inc. free, clear, and harmless for and indemnify Wyoming Gun Company, Inc. from responsibility for any and all claims and demands for personal injury or property damage arising out of such use.

I agree to be held financially responsible for any willful or accidental act of destruction to the range or range equipment, beyond normal wear and tear. This includes shooting baffles.

Fifth Participant's Name

First Name*

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

FIREARMS EXPERIENCE & RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, whether using their own firearm or a Wyoming Gun Company rental firearm MUST completely fill out this form.  All information supplied will be kept strictly confidential, not distributed or made available to others for any purpose and is for the sole use by Wyoming Gun Company to properly identify the user and document their previous firearms experience.  This is being done to ensure the safety of all range users. This form will be completed one time but will be maintained as a matter of record of liability waiver for all subsequent visits.

FILLED OUT ON FIRST VISIT ONLY

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*
Have you ever been adjudicated as mentally defective, been committed to a mental institution, or have a history of mental illness?*
No
Yes
Have you ever been convicted of a FELONY or otherwise prohibited from handling or possessing firearms?*
No
Yes
Are you an unlawful user, or addicted to, marijuana, or any Depressant, stimulant, or narcotic drug, or any other controlled substance?*
No
Yes

Applicant, for itself and its executors and assigns, releases Wyoming Gun Company, Inc. from any and all liability for personal injury or property damage arising out of the use of the equipment and /or facilities of Wyoming Gun Company, Inc. and agrees to hold Wyoming Gun Company, Inc. free, clear, and harmless for and indemnify Wyoming Gun Company, Inc. from responsibility for any and all claims and demands for personal injury or property damage arising out of such use.

I agree to be held financially responsible for any willful or accidental act of destruction to the range or range equipment, beyond normal wear and tear. This includes shooting baffles.

Sixth Participant's Name

First Name*

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

FIREARMS EXPERIENCE & RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, whether using their own firearm or a Wyoming Gun Company rental firearm MUST completely fill out this form.  All information supplied will be kept strictly confidential, not distributed or made available to others for any purpose and is for the sole use by Wyoming Gun Company to properly identify the user and document their previous firearms experience.  This is being done to ensure the safety of all range users. This form will be completed one time but will be maintained as a matter of record of liability waiver for all subsequent visits.

FILLED OUT ON FIRST VISIT ONLY

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*
Have you ever been adjudicated as mentally defective, been committed to a mental institution, or have a history of mental illness?*
No
Yes
Have you ever been convicted of a FELONY or otherwise prohibited from handling or possessing firearms?*
No
Yes
Are you an unlawful user, or addicted to, marijuana, or any Depressant, stimulant, or narcotic drug, or any other controlled substance?*
No
Yes

Applicant, for itself and its executors and assigns, releases Wyoming Gun Company, Inc. from any and all liability for personal injury or property damage arising out of the use of the equipment and /or facilities of Wyoming Gun Company, Inc. and agrees to hold Wyoming Gun Company, Inc. free, clear, and harmless for and indemnify Wyoming Gun Company, Inc. from responsibility for any and all claims and demands for personal injury or property damage arising out of such use.

I agree to be held financially responsible for any willful or accidental act of destruction to the range or range equipment, beyond normal wear and tear. This includes shooting baffles.

Seventh Participant's Name

First Name*

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

FIREARMS EXPERIENCE & RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, whether using their own firearm or a Wyoming Gun Company rental firearm MUST completely fill out this form.  All information supplied will be kept strictly confidential, not distributed or made available to others for any purpose and is for the sole use by Wyoming Gun Company to properly identify the user and document their previous firearms experience.  This is being done to ensure the safety of all range users. This form will be completed one time but will be maintained as a matter of record of liability waiver for all subsequent visits.

FILLED OUT ON FIRST VISIT ONLY

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*
Have you ever been adjudicated as mentally defective, been committed to a mental institution, or have a history of mental illness?*
No
Yes
Have you ever been convicted of a FELONY or otherwise prohibited from handling or possessing firearms?*
No
Yes
Are you an unlawful user, or addicted to, marijuana, or any Depressant, stimulant, or narcotic drug, or any other controlled substance?*
No
Yes

Applicant, for itself and its executors and assigns, releases Wyoming Gun Company, Inc. from any and all liability for personal injury or property damage arising out of the use of the equipment and /or facilities of Wyoming Gun Company, Inc. and agrees to hold Wyoming Gun Company, Inc. free, clear, and harmless for and indemnify Wyoming Gun Company, Inc. from responsibility for any and all claims and demands for personal injury or property damage arising out of such use.

I agree to be held financially responsible for any willful or accidental act of destruction to the range or range equipment, beyond normal wear and tear. This includes shooting baffles.

Eighth Participant's Name

First Name*

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

FIREARMS EXPERIENCE & RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, whether using their own firearm or a Wyoming Gun Company rental firearm MUST completely fill out this form.  All information supplied will be kept strictly confidential, not distributed or made available to others for any purpose and is for the sole use by Wyoming Gun Company to properly identify the user and document their previous firearms experience.  This is being done to ensure the safety of all range users. This form will be completed one time but will be maintained as a matter of record of liability waiver for all subsequent visits.

FILLED OUT ON FIRST VISIT ONLY

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*
Have you ever been adjudicated as mentally defective, been committed to a mental institution, or have a history of mental illness?*
No
Yes
Have you ever been convicted of a FELONY or otherwise prohibited from handling or possessing firearms?*
No
Yes
Are you an unlawful user, or addicted to, marijuana, or any Depressant, stimulant, or narcotic drug, or any other controlled substance?*
No
Yes

Applicant, for itself and its executors and assigns, releases Wyoming Gun Company, Inc. from any and all liability for personal injury or property damage arising out of the use of the equipment and /or facilities of Wyoming Gun Company, Inc. and agrees to hold Wyoming Gun Company, Inc. free, clear, and harmless for and indemnify Wyoming Gun Company, Inc. from responsibility for any and all claims and demands for personal injury or property damage arising out of such use.

I agree to be held financially responsible for any willful or accidental act of destruction to the range or range equipment, beyond normal wear and tear. This includes shooting baffles.

Ninth Participant's Name

First Name*

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

FIREARMS EXPERIENCE & RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, whether using their own firearm or a Wyoming Gun Company rental firearm MUST completely fill out this form.  All information supplied will be kept strictly confidential, not distributed or made available to others for any purpose and is for the sole use by Wyoming Gun Company to properly identify the user and document their previous firearms experience.  This is being done to ensure the safety of all range users. This form will be completed one time but will be maintained as a matter of record of liability waiver for all subsequent visits.

FILLED OUT ON FIRST VISIT ONLY

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*
Have you ever been adjudicated as mentally defective, been committed to a mental institution, or have a history of mental illness?*
No
Yes
Have you ever been convicted of a FELONY or otherwise prohibited from handling or possessing firearms?*
No
Yes
Are you an unlawful user, or addicted to, marijuana, or any Depressant, stimulant, or narcotic drug, or any other controlled substance?*
No
Yes

Applicant, for itself and its executors and assigns, releases Wyoming Gun Company, Inc. from any and all liability for personal injury or property damage arising out of the use of the equipment and /or facilities of Wyoming Gun Company, Inc. and agrees to hold Wyoming Gun Company, Inc. free, clear, and harmless for and indemnify Wyoming Gun Company, Inc. from responsibility for any and all claims and demands for personal injury or property damage arising out of such use.

I agree to be held financially responsible for any willful or accidental act of destruction to the range or range equipment, beyond normal wear and tear. This includes shooting baffles.

Tenth Participant's Name

First Name*

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

FIREARMS EXPERIENCE & RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, whether using their own firearm or a Wyoming Gun Company rental firearm MUST completely fill out this form.  All information supplied will be kept strictly confidential, not distributed or made available to others for any purpose and is for the sole use by Wyoming Gun Company to properly identify the user and document their previous firearms experience.  This is being done to ensure the safety of all range users. This form will be completed one time but will be maintained as a matter of record of liability waiver for all subsequent visits.

FILLED OUT ON FIRST VISIT ONLY

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*
Have you ever been adjudicated as mentally defective, been committed to a mental institution, or have a history of mental illness?*
No
Yes
Have you ever been convicted of a FELONY or otherwise prohibited from handling or possessing firearms?*
No
Yes
Are you an unlawful user, or addicted to, marijuana, or any Depressant, stimulant, or narcotic drug, or any other controlled substance?*
No
Yes

Applicant, for itself and its executors and assigns, releases Wyoming Gun Company, Inc. from any and all liability for personal injury or property damage arising out of the use of the equipment and /or facilities of Wyoming Gun Company, Inc. and agrees to hold Wyoming Gun Company, Inc. free, clear, and harmless for and indemnify Wyoming Gun Company, Inc. from responsibility for any and all claims and demands for personal injury or property damage arising out of such use.

I agree to be held financially responsible for any willful or accidental act of destruction to the range or range equipment, beyond normal wear and tear. This includes shooting baffles.

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
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
Click to customize section title
Click to customize question*
No
Yes
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*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

FIREARMS EXPERIENCE & RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, whether using their own firearm or a Wyoming Gun Company rental firearm MUST completely fill out this form.  All information supplied will be kept strictly confidential, not distributed or made available to others for any purpose and is for the sole use by Wyoming Gun Company to properly identify the user and document their previous firearms experience.  This is being done to ensure the safety of all range users. This form will be completed one time but will be maintained as a matter of record of liability waiver for all subsequent visits.

FILLED OUT ON FIRST VISIT ONLY

I would rate my previous experience with firearms as:

Handgun*
Rifle*
Shotgun*
Have you ever been adjudicated as mentally defective, been committed to a mental institution, or have a history of mental illness?*
No
Yes
Have you ever been convicted of a FELONY or otherwise prohibited from handling or possessing firearms?*
No
Yes
Are you an unlawful user, or addicted to, marijuana, or any Depressant, stimulant, or narcotic drug, or any other controlled substance?*
No
Yes

Applicant, for itself and its executors and assigns, releases Wyoming Gun Company, Inc. from any and all liability for personal injury or property damage arising out of the use of the equipment and /or facilities of Wyoming Gun Company, Inc. and agrees to hold Wyoming Gun Company, Inc. free, clear, and harmless for and indemnify Wyoming Gun Company, Inc. from responsibility for any and all claims and demands for personal injury or property damage arising out of such use.

I agree to be held financially responsible for any willful or accidental act of destruction to the range or range equipment, beyond normal wear and tear. This includes shooting baffles.

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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