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Double Eagle Pocono LLC / Eagle Outdoor LLC

332 RT 447, Newfoundland, PA 18445

Release, Assumption of Risk and Indemnity Agreement

I acknowledge and understand that outdoor and shooting activities are inherently hazardous and involve both known and unanticipated risks which can, may and will result in damage or destruction of property and physical or emotional injury, including paralysis or death, of myself or of other persons. These risks include, but are not limited to: being shot by or shooting myself or others; partial or total loss of eyesight or hearing; inhalation or other harmful contact with lead or other contaminants; and being struck by flying or falling objects. I further understand that the discharging of firearms and the use of ammunition have inherent dangers that no amount of care, instruction, or expertise can eliminate. I further acknowledge and understand that the Eagle Outdoor is an outdoor shooting facility which utilizes a series of component parts, including a berms and backstops to decelerate discharged ammunition; however, I understand that these component parts and berms of Eagle Outdoor, do not, in every instance, contain bullets or bullet fragments and has been known to cause ricochets which could cause serious personal injury or death. I further acknowledge and understand that Double Eagle Pocono LLC / Eagle Outdoor LLC makes no warranty as to the design, manufacture, condition or fitness for any particular purpose of any range facilities or equipment, including, but not limited to: firearms, ammunition, eye/hearing protection, and first-aid supplies. I represent that I have never been convicted of a felony in any of the 50 United States. US law prohibits any person convicted of a felony to be present in any environment where firearms are present. I represent that I am experienced and skilled in the proper handling, loading, use and discharge of all firearms and ammunition I intend to use at the range. I understand that the range is specifically relying on the truth of my representations concerning my experience with firearms, in permitting me to make use of the range.

As lawful consideration for being permitted by Double Eagle Pocono LLC / Eagle Outdoor LLC to enter on to the range, to use range facilities or equipment and to engage in or observe shooting and other activities at the range, as either a Member or a Guest, I agree as follows:

I agree to assume full responsibility for any and all risks, injuries, or damages, known or unknown, of whatsoever any kind and nature, which I might incur as a result of entering on to the range and in using range facilities or equipment and in engaging in or observing shooting and other activities at the range. I agree to assume all responsibility and liability for any act or acts, even negligent, reckless, or criminal act or omission to act, of my Guests at the range. (I understand that "my Guests" includes any and all persons who enter on to the range, use the range facilities or engage in or observe shooting and other activities at the range as a result of my express invitation, permission or consent). I agree that I will ensure that each of my Guests read and sign a "Release, Assumption of Risk and Indemnity Agreement." Guests also include any MINORS under guardianship of the undersigned (MINOR is defined as any person under the age of 18 on the date the activities on range are to take place). Each MINOR participating in range activities must be included in the GUARDIANSHIP section at the bottom of this document and is therefore also bound by “Release, Assumption of Risk, and Indemnity Agreement.” I agree to abide by Double Eagle Pocono LLC / Eagle Outdoor LLC's Code of Conduct and to ensure my Guests do so as well. I knowingly, voluntarily and expressly waive any and all claims I, my next of kin, heirs, guardians, representatives, assigns or any other person claiming under me completely and without reservation that I may have against the Double Eagle Pocono LLC / Eagle Outdoor LLC ,its agents, officers, members, employees, instructors, volunteers, or representatives from any and all injuries or damages that I may sustain as a result of me entering on to the range, using range facilities or equipment, or engaging in or observing shooting range activities. Also, I, my next of kin, heirs, guardians, representatives, assigns or any other person claiming under me, forever release, waive, discharge and covenant not to sue the Double Eagle Pocono LLC / Eagle Outdoor LLC, its agents, officers, members, employees, instructors, volunteers, or representatives for any personal injury, death, disability, property damage, property theft or acts and/or omissions of whatsoever kind and nature including, but not limited to, those caused by its negligence or other acts including, but not limited to, those acts and/or omissions of other participants or persons at the range.

I further acknowledge and agree that it is my understanding and intent that this Agreement, and any signed written amendments or modifications to it, shall remain in full force and effect from the date of execution and ever after shall be applicable to each and every occasion that I or my Guests enter on to the range, use range facilities or equipment or engage in or observe shooting and other activities at the range. I further agree to accept financial responsibility for the repair of any EQUIPMENT that I rent, borrow, or use that is owned by Double Eagle Pocono LLC / Eagle Outdoor LLC in the event that damages were directly caused by MINE or my GUESTS inappropriate use of said EQUIPMENT.

I hereby consent to and authorize the use of my photos, video, name, and likeness, together with my endorsement or testimonial (whether written, video or oral statement), which may appear in any media form released by Double Eagle Pocono LLC / Eagle Outdoor LLC or their assignees, in commercials promoting and/or creating the product or services associated with Double Eagle Pocono LLC / Eagle Outdoor LLC

TESTIMONIAL / MODEL RELEASE

I hereby consent to and authorize the use of my name, and likeness, together with my endorsement or testimonial (whether written or oral), which may appear in any media form released by Double Eagle Pocono LLC / Eagle Outdoor LLC and/or their assignees, in commercials promoting and/or creating the product or services associated with Double Eagle Pocono LLC / Eagle Outdoor LLC.

I hereby authorize Double Eagle Pocono LLC / Eagle Outdoor LLC or their assignees to use, reproduce, sell, exhibit, broadcast and distribute any promotional materials containing my name and likeness, together with my endorsement or testimonial, without limitation, for the purpose of endorsing any advertised products of Double Eagle Pocono LLC / Eagle Outdoor LLC.

I hereby assign and agree to assign to Double Eagle Pocono LLC / Eagle Outdoor LLC, any and all rights, including in and to any videotapes, still photographs, and any other material made by Double Eagle Pocono LLC / Eagle Outdoor LLC, which contains my name, likeness, endorsement or testimonial.  I agree to execute at a future date any further documents that may be necessary to perfect Double Eagle Pocono LLC / Eagle Outdoor LLC ownership of all rights in any works containing my name, likeness, endorsements or testimonial.  I hereby waive any right to inspect or approve of the finished videotape, sound track or advertising copy, or printed matter that may be used in connection therewith or to the eventual use that it might be applied.

I hereby certify that my testimonial or endorsement of the product(s) appearing on any commercials promoting and/or creating the products and/or services of Double Eagle Pocono LLC / Eagle Outdoor LLC are true and accurate and reflect(s) my honest belief in the quality of the product(s) that I am endorsing.  I have no affiliation or connection with Double Eagle Pocono LLC / Eagle Outdoor LLC, or any person or entity connected.  I am doing this interview of my own free will and I have not paid a monetary sum for doing so.

I have carefully read this "Release, Assumption of Risk and Indemnity Agreement" and fully know its contents. I acknowledge that no other inducement, assurance or guarantee has been made to me in consideration of my signing this Agreement which I sign voluntarily and of my own free will. I further acknowledge and agree that this Agreement may be amended or modified only by a writing signed by me and by an authorized agent of Double Eagle Pocono LLC / Eagle Outdoor LLC.

First Participant's Name

First Name*

Last Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

Email*

Confirm Email*
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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*

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.


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