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RELEASE, WAIVER, INDEMNIFICATION, HOLD HARMLESS,
AND ASSUMPTION OF THE RISK AGREEMENT

WHEREAS, in return for use of premises and equipment, instruction in firearms, & for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Undersigned agrees to the following:
To indemnify, hold harmless and defend Premier Firearms Training LLC and/or Premier Women’s Firearms Training LLC and any of its employees, instructors, independent contractors, directors, officers or agents from any and all fault, liabilities, costs, expenses, claims, demands or lawsuits arising out of, related to or connected with the instruction in or discharge of firearms; the Undersigned’s participation in discharging firearms; observing the discharging of firearms, the range, buildings, land and premises used (the “Premises”); the Undersigned’s presence on or use of Premises; and any and all acts or omissions of the Undersigned. Should any such claim, demand or lawsuit arise or be asserted in any way related thereto, whether arising under the laws of the United States, the State of Florida or any other State, or under any theory of law or equity, the Undersigned will indemnify, hold harmless and defend Premier Firearms Training LLC and/or Premier Women’s Firearms Training LLC, from any and all costs, expenses or liability including, but not limited to, the cost of any settlement or judgment made or rendered against Premier Firearms Training LLC and/or Premier Women’s Firearms Training LLC, whether individually, jointly, or in concert with the Undersigned, together with all costs of court and other costs or expenses incurred in connection with any such claim, demand or lawsuit, including attorney’s fees.

The Undersigned waives any and all rights and claims for damages, losses, demands and any other actions, which exist or which may arise against Premier Firearms Training LLC and/or Premier Women’s Firearms Training LLC, (including, but not limited to any and all injuries, damages or illnesses suffered by the Undersigned or the Undersigned’s property), which may, in any way whatsoever, arise out of, be related to or be connected with: discharging firearms, the Premises, including any latent defect in the Premises; the Undersigned’s presence on or use of Premises; the Undersigned’s property (whether or not entrusted to Premier Firearms Training LLC and/or Premier Women’s Firearms Training LLC); Premier Firearms Training LLC and/or Premier Women’s Firearms Training LLC, shall not be liable for, and the Undersigned, hereby expressly releases Premier Firearms Training LLC and/or Premier Women’s Firearms Training LLC from any and all such claims. This waiver is both personal and on behalf of any minor for whom it is executed.

The Undersigned hereby expressly assumes the risk of entering the Premises and taking part in activities on the Premises which include, but are not limited to the discharge of firearms and the firing of live ammunition; or observing individuals discharging firearms; & the use of the facilities. The Undersigned furthermore hereby acknowledges and agrees that he/she has read, understands and will at all times abide by all Premier Firearms Training LLC and/or Premier Women’s Firearms Training LLC rules, instructions, procedures, safety rules, and any and all Range Officer instructions, whether communicated in writing, posted on the premises & communicated verbally. This instrument binds the Undersigned and his/her executors, administrators, assignees or heirs and any minor for whom it is signed. If under the age of 21, my age is listed. If a minor, under the age of 18 years, I understand a parent or legal guardian’s signature is required.

By signing this waiver I also confirm and attest; that I am not a convicted felon, or under indictment in any court for a crime punishable by imprisonment for a term exceeding one year, I am not a fugitive from justice, I do not use or addicted to any unlawful controlled substances, I have not been adjudicated as a mental defective or have been committed to any mental institution, I am not an illegal alien, have not been discharged from the military under dishonorable conditions, have not renounced my United States citizenship, am not subject to a court order restraining me from harassing, stalking, or threatening an intimate partner or child of the intimate partner, and have never been convicted of a misdemeanor crime of domestic violence. I am not prohibited from the use or possession of firearms by any state or federal laws or regulations. I also further attest to the fact I am not currently under the influence of any substances that may hinder or impede my actions in handling a firearm safely for the intended purposes of this course.

First Participants Name

First Name*

Middle Name

Last Name*

Phone*
First Participants Date of Birth*
First Participants Signature*
Second Participants Name

First Name*

Middle Name

Last Name*
Second Participants Date of Birth*
Third Participants Name

First Name*

Middle Name

Last Name*
Third Participants Date of Birth*
Fourth Participants Name

First Name*

Middle Name

Last Name*
Fourth Participants Date of Birth*
Fifth Participants Name

First Name*

Middle Name

Last Name*
Fifth Participants Date of Birth*
Sixth Participants Name

First Name*

Middle Name

Last Name*
Sixth Participants Date of Birth*
Seventh Participants Name

First Name*

Middle Name

Last Name*
Seventh Participants Date of Birth*
Eighth Participants Name

First Name*

Middle Name

Last Name*
Eighth Participants Date of Birth*
Ninth Participants Name

First Name*

Middle Name

Last Name*
Ninth Participants Date of Birth*
Tenth Participants Name

First Name*

Middle Name

Last Name*
Tenth Participants Date of Birth*
Participants 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 Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
Parent or Guardian Email Address

Email
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Emergency Contact's Relation to Participant
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 Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian Date of Birth*
Parent or Guardian 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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