WeShoot does not share, sell, rent, or lease any information or user lists to third parties.

For the full and updated Privacy Policy, please visit our Website:
http:///www.weshootusa.com/privacy-policy/

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**ONLY FILL OUT THIS WAIVER IF YOU ARE RENTING A FIREARM.**

 

Firearm Rental Qualification

WeShoot reserves the right to refuse service to any person for any reason at any time!

All Federal, State and Local laws apply.

Age Requirements:

Long Gun - Minimum age: 18

Handgun (pistol) - Minimum age: 21


Review WeShoot Privacy Policy

Welcome to WeShoot! Please fill out the waiver. If you need help or have questions, please ask one of our Team members, who will be glad to assist you.
This Firearms Rental Qualification is valid only for today's rentals.

THIS FORM NEEDS TO BE FILLED OUT EVERY TIME, AND ON THE SAME DAY, THAT YOU ARE RENTING A FIREARM.

COVID AND OTHER POTENTIAL DISEASES: The health and safety of our members, customers, guests, and employees is our top priority. We have implemented several measures designed to protect customers, guests, and employees from potential exposure to the COVID-19 virus ("Coronavirus"), by minimizing contacts, promoting social distancing when possible, making free masks available for our customers, students, and staff, and increasing sanitation throughout the range.

Please note that WESHOOT cannot guarantee that you will not be exposed to Coronavirus during your visit. The CDC advises that older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from Coronavirus. Guests should evaluate their own risk in determining whether to attend. People who show no symptoms can spread Coronavirus if they are infected, any interaction with the general public poses an elevated risk of being exposed to Coronavirus. By coming to the range, store, and/or classroom, you acknowledge and agree that you assume these inherent risks associated with attendance. 

Today's Date: June 18, 2021

First Participant's Name

First Name*

Middle Name

Last Name*

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

Do you require an interpreter to complete this form or to understand commands given in the English language?                                  

Español: 

Requieres de los servicios de un interprete para completar esta forma o comprender comandos en inglés?

Hebrew:

?האם אתה זקוק למתרגם כדי למלא טופס זה או להבין את הפקודות שניתנו בשפה האנגלית 

Français:

Avez-vous besoin d'un interprète pour remplir ce formulaire ou pour comprendre les commandes données en anglais?

中文:

您需要口译员来填写此表格或理解英语给出的命令吗?


Interpreter required? / Requiere de interprete? / ?מתורגמן נדרש / interprète requis?*

QUESTIONNAIRE FORM

**PLEASE REVIEW CAREFULLY EACH ANSWER BEFORE YOU SUBMIT THIS FORM, ONCE SUBMITTED, WE CANNOT CHANGE YOUR ANSWERS.**

(1) Have you ever been convicted of a crime that has not been expunged or sealed? *
No
Yes
(2) Are you subject to any court order prohibiting you from possessing firearms? *
No
Yes
(3) Are you subject to any court order issued pursuant to Domestic Violence? *NOTICE: you have had a Final Restraining Order issued against you within the last two years, you must answer "Yes" and are ineligible to possess a firearm. The period of ineligibility is two years from the date of issuance of the Final Restraining Order or the date it was dismissed whichever is longer. *
No
Yes
(4) Have you ever been convicted of a disorderly persons offense or its equivalent, in any jurisdiction, involving an act of domestic violence that involved the offense(s) of (1) Simple Assault (2) False Imprisonment (3) Lewdness (4) Criminal Trespass or (5) Harassment that has not been expunged or sealed? *
No
Yes
(5) Are you an alcoholic? *NOTE: A recovered alcoholic may answer no to this question. *
No
Yes
(6) Are you dependent upon the use of any narcotic or other controlled dangerous substance? *
No
Yes
(7) Do you suffer from any physical defect or sickness which makes it unsafe for you to handle firearms? *
No
Yes
(8) Have you ever been confined for a mental disorder? *
No
Yes
(9) Are you presently, or have you ever been a member of any organization which advocates or approves the commission of acts of violence, either to overthrow the government of the United States or of this State, or to deny others of their rights under the Constitution of either the United States or the State of New Jersey? *
No
Yes
10) Are you a fugitive from justice? *
No
Yes
11) Have you consumed any alcohol or medications that might impair your judgment, actions, or affect your control over your physical movements? *
No
Yes

By my signature, I hereby certify that the answers given on this form are complete, true and correct in every particular. I realize that if any of the foregoing answers made by me are false, I am subject to punishment by law.

First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

Do you require an interpreter to complete this form or to understand commands given in the English language?                                  

Español: 

Requieres de los servicios de un interprete para completar esta forma o comprender comandos en inglés?

Hebrew:

?האם אתה זקוק למתרגם כדי למלא טופס זה או להבין את הפקודות שניתנו בשפה האנגלית 

Français:

Avez-vous besoin d'un interprète pour remplir ce formulaire ou pour comprendre les commandes données en anglais?

中文:

您需要口译员来填写此表格或理解英语给出的命令吗?


Interpreter required? / Requiere de interprete? / ?מתורגמן נדרש / interprète requis?*

QUESTIONNAIRE FORM

**PLEASE REVIEW CAREFULLY EACH ANSWER BEFORE YOU SUBMIT THIS FORM, ONCE SUBMITTED, WE CANNOT CHANGE YOUR ANSWERS.**

(1) Have you ever been convicted of a crime that has not been expunged or sealed? *
No
Yes
(2) Are you subject to any court order prohibiting you from possessing firearms? *
No
Yes
(3) Are you subject to any court order issued pursuant to Domestic Violence? *NOTICE: you have had a Final Restraining Order issued against you within the last two years, you must answer "Yes" and are ineligible to possess a firearm. The period of ineligibility is two years from the date of issuance of the Final Restraining Order or the date it was dismissed whichever is longer. *
No
Yes
(4) Have you ever been convicted of a disorderly persons offense or its equivalent, in any jurisdiction, involving an act of domestic violence that involved the offense(s) of (1) Simple Assault (2) False Imprisonment (3) Lewdness (4) Criminal Trespass or (5) Harassment that has not been expunged or sealed? *
No
Yes
(5) Are you an alcoholic? *NOTE: A recovered alcoholic may answer no to this question. *
No
Yes
(6) Are you dependent upon the use of any narcotic or other controlled dangerous substance? *
No
Yes
(7) Do you suffer from any physical defect or sickness which makes it unsafe for you to handle firearms? *
No
Yes
(8) Have you ever been confined for a mental disorder? *
No
Yes
(9) Are you presently, or have you ever been a member of any organization which advocates or approves the commission of acts of violence, either to overthrow the government of the United States or of this State, or to deny others of their rights under the Constitution of either the United States or the State of New Jersey? *
No
Yes
10) Are you a fugitive from justice? *
No
Yes
11) Have you consumed any alcohol or medications that might impair your judgment, actions, or affect your control over your physical movements? *
No
Yes

By my signature, I hereby certify that the answers given on this form are complete, true and correct in every particular. I realize that if any of the foregoing answers made by me are false, I am subject to punishment by law.

Third Participant's Name

First Name*

Middle Name

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

Do you require an interpreter to complete this form or to understand commands given in the English language?                                  

Español: 

Requieres de los servicios de un interprete para completar esta forma o comprender comandos en inglés?

Hebrew:

?האם אתה זקוק למתרגם כדי למלא טופס זה או להבין את הפקודות שניתנו בשפה האנגלית 

Français:

Avez-vous besoin d'un interprète pour remplir ce formulaire ou pour comprendre les commandes données en anglais?

中文:

您需要口译员来填写此表格或理解英语给出的命令吗?


Interpreter required? / Requiere de interprete? / ?מתורגמן נדרש / interprète requis?*

QUESTIONNAIRE FORM

**PLEASE REVIEW CAREFULLY EACH ANSWER BEFORE YOU SUBMIT THIS FORM, ONCE SUBMITTED, WE CANNOT CHANGE YOUR ANSWERS.**

(1) Have you ever been convicted of a crime that has not been expunged or sealed? *
No
Yes
(2) Are you subject to any court order prohibiting you from possessing firearms? *
No
Yes
(3) Are you subject to any court order issued pursuant to Domestic Violence? *NOTICE: you have had a Final Restraining Order issued against you within the last two years, you must answer "Yes" and are ineligible to possess a firearm. The period of ineligibility is two years from the date of issuance of the Final Restraining Order or the date it was dismissed whichever is longer. *
No
Yes
(4) Have you ever been convicted of a disorderly persons offense or its equivalent, in any jurisdiction, involving an act of domestic violence that involved the offense(s) of (1) Simple Assault (2) False Imprisonment (3) Lewdness (4) Criminal Trespass or (5) Harassment that has not been expunged or sealed? *
No
Yes
(5) Are you an alcoholic? *NOTE: A recovered alcoholic may answer no to this question. *
No
Yes
(6) Are you dependent upon the use of any narcotic or other controlled dangerous substance? *
No
Yes
(7) Do you suffer from any physical defect or sickness which makes it unsafe for you to handle firearms? *
No
Yes
(8) Have you ever been confined for a mental disorder? *
No
Yes
(9) Are you presently, or have you ever been a member of any organization which advocates or approves the commission of acts of violence, either to overthrow the government of the United States or of this State, or to deny others of their rights under the Constitution of either the United States or the State of New Jersey? *
No
Yes
10) Are you a fugitive from justice? *
No
Yes
11) Have you consumed any alcohol or medications that might impair your judgment, actions, or affect your control over your physical movements? *
No
Yes

By my signature, I hereby certify that the answers given on this form are complete, true and correct in every particular. I realize that if any of the foregoing answers made by me are false, I am subject to punishment by law.

Fourth Participant's Name

First Name*

Middle Name

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

Do you require an interpreter to complete this form or to understand commands given in the English language?                                  

Español: 

Requieres de los servicios de un interprete para completar esta forma o comprender comandos en inglés?

Hebrew:

?האם אתה זקוק למתרגם כדי למלא טופס זה או להבין את הפקודות שניתנו בשפה האנגלית 

Français:

Avez-vous besoin d'un interprète pour remplir ce formulaire ou pour comprendre les commandes données en anglais?

中文:

您需要口译员来填写此表格或理解英语给出的命令吗?


Interpreter required? / Requiere de interprete? / ?מתורגמן נדרש / interprète requis?*

QUESTIONNAIRE FORM

**PLEASE REVIEW CAREFULLY EACH ANSWER BEFORE YOU SUBMIT THIS FORM, ONCE SUBMITTED, WE CANNOT CHANGE YOUR ANSWERS.**

(1) Have you ever been convicted of a crime that has not been expunged or sealed? *
No
Yes
(2) Are you subject to any court order prohibiting you from possessing firearms? *
No
Yes
(3) Are you subject to any court order issued pursuant to Domestic Violence? *NOTICE: you have had a Final Restraining Order issued against you within the last two years, you must answer "Yes" and are ineligible to possess a firearm. The period of ineligibility is two years from the date of issuance of the Final Restraining Order or the date it was dismissed whichever is longer. *
No
Yes
(4) Have you ever been convicted of a disorderly persons offense or its equivalent, in any jurisdiction, involving an act of domestic violence that involved the offense(s) of (1) Simple Assault (2) False Imprisonment (3) Lewdness (4) Criminal Trespass or (5) Harassment that has not been expunged or sealed? *
No
Yes
(5) Are you an alcoholic? *NOTE: A recovered alcoholic may answer no to this question. *
No
Yes
(6) Are you dependent upon the use of any narcotic or other controlled dangerous substance? *
No
Yes
(7) Do you suffer from any physical defect or sickness which makes it unsafe for you to handle firearms? *
No
Yes
(8) Have you ever been confined for a mental disorder? *
No
Yes
(9) Are you presently, or have you ever been a member of any organization which advocates or approves the commission of acts of violence, either to overthrow the government of the United States or of this State, or to deny others of their rights under the Constitution of either the United States or the State of New Jersey? *
No
Yes
10) Are you a fugitive from justice? *
No
Yes
11) Have you consumed any alcohol or medications that might impair your judgment, actions, or affect your control over your physical movements? *
No
Yes

By my signature, I hereby certify that the answers given on this form are complete, true and correct in every particular. I realize that if any of the foregoing answers made by me are false, I am subject to punishment by law.

Fifth Participant's Name

First Name*

Middle Name

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

Do you require an interpreter to complete this form or to understand commands given in the English language?                                  

Español: 

Requieres de los servicios de un interprete para completar esta forma o comprender comandos en inglés?

Hebrew:

?האם אתה זקוק למתרגם כדי למלא טופס זה או להבין את הפקודות שניתנו בשפה האנגלית 

Français:

Avez-vous besoin d'un interprète pour remplir ce formulaire ou pour comprendre les commandes données en anglais?

中文:

您需要口译员来填写此表格或理解英语给出的命令吗?


Interpreter required? / Requiere de interprete? / ?מתורגמן נדרש / interprète requis?*

QUESTIONNAIRE FORM

**PLEASE REVIEW CAREFULLY EACH ANSWER BEFORE YOU SUBMIT THIS FORM, ONCE SUBMITTED, WE CANNOT CHANGE YOUR ANSWERS.**

(1) Have you ever been convicted of a crime that has not been expunged or sealed? *
No
Yes
(2) Are you subject to any court order prohibiting you from possessing firearms? *
No
Yes
(3) Are you subject to any court order issued pursuant to Domestic Violence? *NOTICE: you have had a Final Restraining Order issued against you within the last two years, you must answer "Yes" and are ineligible to possess a firearm. The period of ineligibility is two years from the date of issuance of the Final Restraining Order or the date it was dismissed whichever is longer. *
No
Yes
(4) Have you ever been convicted of a disorderly persons offense or its equivalent, in any jurisdiction, involving an act of domestic violence that involved the offense(s) of (1) Simple Assault (2) False Imprisonment (3) Lewdness (4) Criminal Trespass or (5) Harassment that has not been expunged or sealed? *
No
Yes
(5) Are you an alcoholic? *NOTE: A recovered alcoholic may answer no to this question. *
No
Yes
(6) Are you dependent upon the use of any narcotic or other controlled dangerous substance? *
No
Yes
(7) Do you suffer from any physical defect or sickness which makes it unsafe for you to handle firearms? *
No
Yes
(8) Have you ever been confined for a mental disorder? *
No
Yes
(9) Are you presently, or have you ever been a member of any organization which advocates or approves the commission of acts of violence, either to overthrow the government of the United States or of this State, or to deny others of their rights under the Constitution of either the United States or the State of New Jersey? *
No
Yes
10) Are you a fugitive from justice? *
No
Yes
11) Have you consumed any alcohol or medications that might impair your judgment, actions, or affect your control over your physical movements? *
No
Yes

By my signature, I hereby certify that the answers given on this form are complete, true and correct in every particular. I realize that if any of the foregoing answers made by me are false, I am subject to punishment by law.

Sixth Participant's Name

First Name*

Middle Name

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

Do you require an interpreter to complete this form or to understand commands given in the English language?                                  

Español: 

Requieres de los servicios de un interprete para completar esta forma o comprender comandos en inglés?

Hebrew:

?האם אתה זקוק למתרגם כדי למלא טופס זה או להבין את הפקודות שניתנו בשפה האנגלית 

Français:

Avez-vous besoin d'un interprète pour remplir ce formulaire ou pour comprendre les commandes données en anglais?

中文:

您需要口译员来填写此表格或理解英语给出的命令吗?


Interpreter required? / Requiere de interprete? / ?מתורגמן נדרש / interprète requis?*

QUESTIONNAIRE FORM

**PLEASE REVIEW CAREFULLY EACH ANSWER BEFORE YOU SUBMIT THIS FORM, ONCE SUBMITTED, WE CANNOT CHANGE YOUR ANSWERS.**

(1) Have you ever been convicted of a crime that has not been expunged or sealed? *
No
Yes
(2) Are you subject to any court order prohibiting you from possessing firearms? *
No
Yes
(3) Are you subject to any court order issued pursuant to Domestic Violence? *NOTICE: you have had a Final Restraining Order issued against you within the last two years, you must answer "Yes" and are ineligible to possess a firearm. The period of ineligibility is two years from the date of issuance of the Final Restraining Order or the date it was dismissed whichever is longer. *
No
Yes
(4) Have you ever been convicted of a disorderly persons offense or its equivalent, in any jurisdiction, involving an act of domestic violence that involved the offense(s) of (1) Simple Assault (2) False Imprisonment (3) Lewdness (4) Criminal Trespass or (5) Harassment that has not been expunged or sealed? *
No
Yes
(5) Are you an alcoholic? *NOTE: A recovered alcoholic may answer no to this question. *
No
Yes
(6) Are you dependent upon the use of any narcotic or other controlled dangerous substance? *
No
Yes
(7) Do you suffer from any physical defect or sickness which makes it unsafe for you to handle firearms? *
No
Yes
(8) Have you ever been confined for a mental disorder? *
No
Yes
(9) Are you presently, or have you ever been a member of any organization which advocates or approves the commission of acts of violence, either to overthrow the government of the United States or of this State, or to deny others of their rights under the Constitution of either the United States or the State of New Jersey? *
No
Yes
10) Are you a fugitive from justice? *
No
Yes
11) Have you consumed any alcohol or medications that might impair your judgment, actions, or affect your control over your physical movements? *
No
Yes

By my signature, I hereby certify that the answers given on this form are complete, true and correct in every particular. I realize that if any of the foregoing answers made by me are false, I am subject to punishment by law.

Seventh Participant's Name

First Name*

Middle Name

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

Do you require an interpreter to complete this form or to understand commands given in the English language?                                  

Español: 

Requieres de los servicios de un interprete para completar esta forma o comprender comandos en inglés?

Hebrew:

?האם אתה זקוק למתרגם כדי למלא טופס זה או להבין את הפקודות שניתנו בשפה האנגלית 

Français:

Avez-vous besoin d'un interprète pour remplir ce formulaire ou pour comprendre les commandes données en anglais?

中文:

您需要口译员来填写此表格或理解英语给出的命令吗?


Interpreter required? / Requiere de interprete? / ?מתורגמן נדרש / interprète requis?*

QUESTIONNAIRE FORM

**PLEASE REVIEW CAREFULLY EACH ANSWER BEFORE YOU SUBMIT THIS FORM, ONCE SUBMITTED, WE CANNOT CHANGE YOUR ANSWERS.**

(1) Have you ever been convicted of a crime that has not been expunged or sealed? *
No
Yes
(2) Are you subject to any court order prohibiting you from possessing firearms? *
No
Yes
(3) Are you subject to any court order issued pursuant to Domestic Violence? *NOTICE: you have had a Final Restraining Order issued against you within the last two years, you must answer "Yes" and are ineligible to possess a firearm. The period of ineligibility is two years from the date of issuance of the Final Restraining Order or the date it was dismissed whichever is longer. *
No
Yes
(4) Have you ever been convicted of a disorderly persons offense or its equivalent, in any jurisdiction, involving an act of domestic violence that involved the offense(s) of (1) Simple Assault (2) False Imprisonment (3) Lewdness (4) Criminal Trespass or (5) Harassment that has not been expunged or sealed? *
No
Yes
(5) Are you an alcoholic? *NOTE: A recovered alcoholic may answer no to this question. *
No
Yes
(6) Are you dependent upon the use of any narcotic or other controlled dangerous substance? *
No
Yes
(7) Do you suffer from any physical defect or sickness which makes it unsafe for you to handle firearms? *
No
Yes
(8) Have you ever been confined for a mental disorder? *
No
Yes
(9) Are you presently, or have you ever been a member of any organization which advocates or approves the commission of acts of violence, either to overthrow the government of the United States or of this State, or to deny others of their rights under the Constitution of either the United States or the State of New Jersey? *
No
Yes
10) Are you a fugitive from justice? *
No
Yes
11) Have you consumed any alcohol or medications that might impair your judgment, actions, or affect your control over your physical movements? *
No
Yes

By my signature, I hereby certify that the answers given on this form are complete, true and correct in every particular. I realize that if any of the foregoing answers made by me are false, I am subject to punishment by law.

Eighth Participant's Name

First Name*

Middle Name

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

Do you require an interpreter to complete this form or to understand commands given in the English language?                                  

Español: 

Requieres de los servicios de un interprete para completar esta forma o comprender comandos en inglés?

Hebrew:

?האם אתה זקוק למתרגם כדי למלא טופס זה או להבין את הפקודות שניתנו בשפה האנגלית 

Français:

Avez-vous besoin d'un interprète pour remplir ce formulaire ou pour comprendre les commandes données en anglais?

中文:

您需要口译员来填写此表格或理解英语给出的命令吗?


Interpreter required? / Requiere de interprete? / ?מתורגמן נדרש / interprète requis?*

QUESTIONNAIRE FORM

**PLEASE REVIEW CAREFULLY EACH ANSWER BEFORE YOU SUBMIT THIS FORM, ONCE SUBMITTED, WE CANNOT CHANGE YOUR ANSWERS.**

(1) Have you ever been convicted of a crime that has not been expunged or sealed? *
No
Yes
(2) Are you subject to any court order prohibiting you from possessing firearms? *
No
Yes
(3) Are you subject to any court order issued pursuant to Domestic Violence? *NOTICE: you have had a Final Restraining Order issued against you within the last two years, you must answer "Yes" and are ineligible to possess a firearm. The period of ineligibility is two years from the date of issuance of the Final Restraining Order or the date it was dismissed whichever is longer. *
No
Yes
(4) Have you ever been convicted of a disorderly persons offense or its equivalent, in any jurisdiction, involving an act of domestic violence that involved the offense(s) of (1) Simple Assault (2) False Imprisonment (3) Lewdness (4) Criminal Trespass or (5) Harassment that has not been expunged or sealed? *
No
Yes
(5) Are you an alcoholic? *NOTE: A recovered alcoholic may answer no to this question. *
No
Yes
(6) Are you dependent upon the use of any narcotic or other controlled dangerous substance? *
No
Yes
(7) Do you suffer from any physical defect or sickness which makes it unsafe for you to handle firearms? *
No
Yes
(8) Have you ever been confined for a mental disorder? *
No
Yes
(9) Are you presently, or have you ever been a member of any organization which advocates or approves the commission of acts of violence, either to overthrow the government of the United States or of this State, or to deny others of their rights under the Constitution of either the United States or the State of New Jersey? *
No
Yes
10) Are you a fugitive from justice? *
No
Yes
11) Have you consumed any alcohol or medications that might impair your judgment, actions, or affect your control over your physical movements? *
No
Yes

By my signature, I hereby certify that the answers given on this form are complete, true and correct in every particular. I realize that if any of the foregoing answers made by me are false, I am subject to punishment by law.

Ninth Participant's Name

First Name*

Middle Name

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

Do you require an interpreter to complete this form or to understand commands given in the English language?                                  

Español: 

Requieres de los servicios de un interprete para completar esta forma o comprender comandos en inglés?

Hebrew:

?האם אתה זקוק למתרגם כדי למלא טופס זה או להבין את הפקודות שניתנו בשפה האנגלית 

Français:

Avez-vous besoin d'un interprète pour remplir ce formulaire ou pour comprendre les commandes données en anglais?

中文:

您需要口译员来填写此表格或理解英语给出的命令吗?


Interpreter required? / Requiere de interprete? / ?מתורגמן נדרש / interprète requis?*

QUESTIONNAIRE FORM

**PLEASE REVIEW CAREFULLY EACH ANSWER BEFORE YOU SUBMIT THIS FORM, ONCE SUBMITTED, WE CANNOT CHANGE YOUR ANSWERS.**

(1) Have you ever been convicted of a crime that has not been expunged or sealed? *
No
Yes
(2) Are you subject to any court order prohibiting you from possessing firearms? *
No
Yes
(3) Are you subject to any court order issued pursuant to Domestic Violence? *NOTICE: you have had a Final Restraining Order issued against you within the last two years, you must answer "Yes" and are ineligible to possess a firearm. The period of ineligibility is two years from the date of issuance of the Final Restraining Order or the date it was dismissed whichever is longer. *
No
Yes
(4) Have you ever been convicted of a disorderly persons offense or its equivalent, in any jurisdiction, involving an act of domestic violence that involved the offense(s) of (1) Simple Assault (2) False Imprisonment (3) Lewdness (4) Criminal Trespass or (5) Harassment that has not been expunged or sealed? *
No
Yes
(5) Are you an alcoholic? *NOTE: A recovered alcoholic may answer no to this question. *
No
Yes
(6) Are you dependent upon the use of any narcotic or other controlled dangerous substance? *
No
Yes
(7) Do you suffer from any physical defect or sickness which makes it unsafe for you to handle firearms? *
No
Yes
(8) Have you ever been confined for a mental disorder? *
No
Yes
(9) Are you presently, or have you ever been a member of any organization which advocates or approves the commission of acts of violence, either to overthrow the government of the United States or of this State, or to deny others of their rights under the Constitution of either the United States or the State of New Jersey? *
No
Yes
10) Are you a fugitive from justice? *
No
Yes
11) Have you consumed any alcohol or medications that might impair your judgment, actions, or affect your control over your physical movements? *
No
Yes

By my signature, I hereby certify that the answers given on this form are complete, true and correct in every particular. I realize that if any of the foregoing answers made by me are false, I am subject to punishment by law.

Tenth Participant's Name

First Name*

Middle Name

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

Do you require an interpreter to complete this form or to understand commands given in the English language?                                  

Español: 

Requieres de los servicios de un interprete para completar esta forma o comprender comandos en inglés?

Hebrew:

?האם אתה זקוק למתרגם כדי למלא טופס זה או להבין את הפקודות שניתנו בשפה האנגלית 

Français:

Avez-vous besoin d'un interprète pour remplir ce formulaire ou pour comprendre les commandes données en anglais?

中文:

您需要口译员来填写此表格或理解英语给出的命令吗?


Interpreter required? / Requiere de interprete? / ?מתורגמן נדרש / interprète requis?*

QUESTIONNAIRE FORM

**PLEASE REVIEW CAREFULLY EACH ANSWER BEFORE YOU SUBMIT THIS FORM, ONCE SUBMITTED, WE CANNOT CHANGE YOUR ANSWERS.**

(1) Have you ever been convicted of a crime that has not been expunged or sealed? *
No
Yes
(2) Are you subject to any court order prohibiting you from possessing firearms? *
No
Yes
(3) Are you subject to any court order issued pursuant to Domestic Violence? *NOTICE: you have had a Final Restraining Order issued against you within the last two years, you must answer "Yes" and are ineligible to possess a firearm. The period of ineligibility is two years from the date of issuance of the Final Restraining Order or the date it was dismissed whichever is longer. *
No
Yes
(4) Have you ever been convicted of a disorderly persons offense or its equivalent, in any jurisdiction, involving an act of domestic violence that involved the offense(s) of (1) Simple Assault (2) False Imprisonment (3) Lewdness (4) Criminal Trespass or (5) Harassment that has not been expunged or sealed? *
No
Yes
(5) Are you an alcoholic? *NOTE: A recovered alcoholic may answer no to this question. *
No
Yes
(6) Are you dependent upon the use of any narcotic or other controlled dangerous substance? *
No
Yes
(7) Do you suffer from any physical defect or sickness which makes it unsafe for you to handle firearms? *
No
Yes
(8) Have you ever been confined for a mental disorder? *
No
Yes
(9) Are you presently, or have you ever been a member of any organization which advocates or approves the commission of acts of violence, either to overthrow the government of the United States or of this State, or to deny others of their rights under the Constitution of either the United States or the State of New Jersey? *
No
Yes
10) Are you a fugitive from justice? *
No
Yes
11) Have you consumed any alcohol or medications that might impair your judgment, actions, or affect your control over your physical movements? *
No
Yes

By my signature, I hereby certify that the answers given on this form are complete, true and correct in every particular. I realize that if any of the foregoing answers made by me are false, I am subject to punishment by law.

Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive relevant information and discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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*

Middle Name

Last Name*

Relationship*

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

Do you require an interpreter to complete this form or to understand commands given in the English language?                                  

Español: 

Requieres de los servicios de un interprete para completar esta forma o comprender comandos en inglés?

Hebrew:

?האם אתה זקוק למתרגם כדי למלא טופס זה או להבין את הפקודות שניתנו בשפה האנגלית 

Français:

Avez-vous besoin d'un interprète pour remplir ce formulaire ou pour comprendre les commandes données en anglais?

中文:

您需要口译员来填写此表格或理解英语给出的命令吗?


Interpreter required? / Requiere de interprete? / ?מתורגמן נדרש / interprète requis?*

QUESTIONNAIRE FORM

**PLEASE REVIEW CAREFULLY EACH ANSWER BEFORE YOU SUBMIT THIS FORM, ONCE SUBMITTED, WE CANNOT CHANGE YOUR ANSWERS.**

(1) Have you ever been convicted of a crime that has not been expunged or sealed? *
No
Yes
(2) Are you subject to any court order prohibiting you from possessing firearms? *
No
Yes
(3) Are you subject to any court order issued pursuant to Domestic Violence? *NOTICE: you have had a Final Restraining Order issued against you within the last two years, you must answer "Yes" and are ineligible to possess a firearm. The period of ineligibility is two years from the date of issuance of the Final Restraining Order or the date it was dismissed whichever is longer. *
No
Yes
(4) Have you ever been convicted of a disorderly persons offense or its equivalent, in any jurisdiction, involving an act of domestic violence that involved the offense(s) of (1) Simple Assault (2) False Imprisonment (3) Lewdness (4) Criminal Trespass or (5) Harassment that has not been expunged or sealed? *
No
Yes
(5) Are you an alcoholic? *NOTE: A recovered alcoholic may answer no to this question. *
No
Yes
(6) Are you dependent upon the use of any narcotic or other controlled dangerous substance? *
No
Yes
(7) Do you suffer from any physical defect or sickness which makes it unsafe for you to handle firearms? *
No
Yes
(8) Have you ever been confined for a mental disorder? *
No
Yes
(9) Are you presently, or have you ever been a member of any organization which advocates or approves the commission of acts of violence, either to overthrow the government of the United States or of this State, or to deny others of their rights under the Constitution of either the United States or the State of New Jersey? *
No
Yes
10) Are you a fugitive from justice? *
No
Yes
11) Have you consumed any alcohol or medications that might impair your judgment, actions, or affect your control over your physical movements? *
No
Yes

By my signature, I hereby certify that the answers given on this form are complete, true and correct in every particular. I realize that if any of the foregoing answers made by me are false, I am subject to punishment by law.

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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