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FIREARM THERE IS INHERENT RISK. BY EXECUTION OF THIS DOCUMENT, THE UNDERSIGNED REPRESENTS TO THE RANGE THAT HE/SHE IS AN EXPEREINCED SHOOTER. THE UNDERSIGNED IS AWARE OF THE RISK OF OPERATING FIREARMS IN A CONFINED SPACE, FURTHER ACKNOWLEDGING SUCH RISK AND HAVING AN OPPORTUNITY TO EVALUATE THE SAME. THIS ACKNOWLEDGMENT, ASSUMPTION OF RISK, WAIVER OF LIABILITY, AND RELEASE OF CLAIMS, GIVEN IN FAVOR OF RAYMOND ERIC ADCOCK, THE OFFICERS, AGENTS, ASSOCIATES, EMPLOYEES, CONTRACTORS, AND ALL AFFILIATED BUSINESS/PERSONAL ENTITIES OF SHOTS FIRED INDOOR GUN RANGE IS MADE IN CONSIDERATION FOR SHOTS FIRED RANGE CUSTOMER/USER, TO ENTER AND USE THE INDOOR GUN RANGE LOCATED AT 8175 WASHINGTON STREET, COVINGTON, GA AND THE EQUIPMENT LOCATED THEREIN.

1.   SHOTS FIRED INDOOR GUN RANGE is defined and includes officers, agents, associates, employees, contractors, all affiliated business/personal entities, vendors, suppliers, and any person or business that is connected and/or related to SHOTS FIRED INDOOR GUN RANGE.

2.   CUSTOMERS/USERS are defined as each individual who enters the SHOTS FIRED INDOOR GUN RANGE at 8175 WASHINGTON STREET, COVINGTON, GA.

3.   RELEASED PARTIES are defined as SHOTS FIRED INDOOR GUN RANGE, including but not limited to its officers, agents, associates, employees, contractors, and all affiliated business/personal entities with any interest and/or ownership in SHOTS FIRED INDOOR GUN RANGE.

4.   The customer/user acknowledges that he or she is at least 18 years of age. If a minor, the customer/user is accompanied by the customer/user's parent or legal guardian who proclaims and warrants that the statements contained herein are true and accurate. Customer/user states that he/she is mentally and physically capable of safely operating a firearm, handling ammunition or any firearm equipment. Customer/user is allowed by federal and state law to handle and operate a firearm or firearms. Customer/user has not committed a felony and is not prohibited by federal or state law from owning or operating firearms. 

5.   Customers/users have read and understand the SHOTS FIRED INDOOR GUN RANGE safety rules and will completely obey the rules set forth. ALL rules and safety regulations will be strictly enforced and obeyed. In the event that the safety rules are not strictly obeyed, customer/user will be immediately asked to leave SHOTS FIRED INDOOR GUN RANGE without refund.

6.   Customer/user recognizes that lead in ammunition is hazardous material that can cause serious illness, injury, or death if inhaled or absorbed by the customer/user’s person or body. It is recommended that the customer/user washes their hands and face upon leaving SHOTS FIRED INDOOR GUN RANGE. These potential hazards may be caused by the customer/user's own negligence or by the fault of others.

7.   Customer recognizes that the environment or a firearms range can be dangerous, can cause injury, permanent injury or death. These potential hazards may be caused by the customer/user’s own negligence or by the fault of others.

8.   Customer/user is aware of the risks involved and knowingly and voluntarily assumes all risks, known and unknown, past, present, or future, whether caused by customer/user’s negligence or the negligence of others.

9.   Customer forever waives and releases any rights, claim, legal suit/action, infringement, demand, legal or personal cost against SHOTS FIRED INDOOR GUN RANGE or any other persons associated.

10. Customer shall indemnify, defend, protect, and hold harmless the released parties from and against every and all demands, damages, and losses including, but not limited to litigation expenses, attorney fees, or other costs resulting from any actions, judgements, suits, charges, or claims, asserted against, suffered of or incurred by the released parties, whether they are based on released parties negligence, or otherwise. However, such indemnity shall not apply to any released parties to the extent that the subject of the indemnification is caused by the released party’s willful misconduct or gross negligence. The forgoing indemnity shall not terminate upon the completion of the customers uses of the premises or equipment of SHOTS FIRED INDOOR GUN RANGE. This agreement shall survive for all applicable periods of limitation of actions, plus the duration of all claims, litigations of actions, plus the duration of all claims, litigations and appeals arising in any way from the customer of the premises equipment of SHOTS FIRED INDOOR GUN RANGE.

11. This document is intended to be a Continuing Waiver and shall continue to effect for all visits by the undersigned to the SHOTS FIRED INDOOR GUN RANGE. This document is prepared and executed pursuant to GA Code 1981, 44-2-37, enacted by GA. P. 695, 1/HB 127. Accordingly, an electronic version may be utilized as an original without further verification.

12. I COMPLETLEY UNDERSTAND ALL OF THE ABOVE AND WILL STRICTLY FOLLOW AND OBEY ALL LISTED RULES AND REGULATIONS.

13. RENTALS ARE LIMITED TO 18 YEARS OF AGE OR OLDER. PARENTS ARE NOT ALLOWED TO RENT GUNS FOR ANYONE UNDER 18 YEARS OF AGE. HANDGUN RENTALS MUST BE 21 OR OLDER..

Date: April 20, 2024 





First Participant's Name

First Name*

Last Name*

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

Drivers License/ID # *

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT PHONE # *
First Participant's Signature*
Second Participant's Name

First Name*

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

Drivers License/ID # *

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT PHONE # *
Third Participant's Name

First Name*

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

Drivers License/ID # *

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT PHONE # *
Fourth Participant's Name

First Name*

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

Drivers License/ID # *

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT PHONE # *
Fifth Participant's Name

First Name*

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

Drivers License/ID # *

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT PHONE # *
Sixth Participant's Name

First Name*

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

Drivers License/ID # *

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT PHONE # *
Seventh Participant's Name

First Name*

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

Drivers License/ID # *

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT PHONE # *
Eighth Participant's Name

First Name*

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

Drivers License/ID # *

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT PHONE # *
Ninth Participant's Name

First Name*

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

Drivers License/ID # *

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT PHONE # *
Tenth Participant's Name

First Name*

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

Drivers License/ID # *

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT PHONE # *
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
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*

Last Name*

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

Drivers License/ID # *

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT PHONE # *
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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