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This waiver must be completed before the scheduled range time. In addition to this waiver, you must watch the range safety video.

Voluntary Participation 

I acknowledge that I have voluntarily applied to participate in the use of firearms during a class, course or shooting experience with Range Day Tactical Therapy LLC and their agents, owners, officers, volunteers, participants, employees and all persons acting in any capacity on their behalf. I also acknowledge that I have been provided instructions relating to safety in the form of a written copy of Range Day Tactical Therapy LLC’s Range Standard Operating Procedures (“SOP’s”), NRA Firearm Safety Rules and posted regulations. 

 

Acknowledgment of Risk 

I am aware that the use of firearms is an inherently hazardous activity. I acknowledge that my participation in this training class/course or experience entails both anticipated and unanticipated risks which could result in a physical injury, emotional injury, paralysis, death or damage to property or to third party. IN SHORT, I ACKNOWLEDGE THAT I MAY BE KILLED OR SERIOUSLY INJURED BY BEING HERE. THE RISKS INCLUDE BUT ARE NOT LIMITED TO: SHOOTING MYSELF OR BEING SHOT BY THIRD PARTIES, SUFFERING HEARING LOSS, BODILY INJURY, LOSS OF EYESIGHT OR INHALATION OF OR CONTACT WITH AIRBORNE CONTAMINANTS OR FLYING DEBRIS. Furthermore I acknowledge that Range Day Tactical Therapy LLC instructors and/or Range Safety Officers have a difficult job to perform. I am aware that they strive to provide a safe training environment in the classroom and on the range, but they are not infallible. They may be ignorant of my fitness and/or abilities and they may give inadequate warnings or instructions. The equipment being used by me or by a third-party may malfunction. I understand that such risks cannot be eliminated without jeopardizing the essential qualities of this activity. My participation in this activity is purely voluntary and I elect to participate in spite of the risks. I expressly agree and promise to accept all risks existing in this activity and by signing, verify these statements to be true.

 

Release of Liability 

As a consideration for being permitted by Range Day Tactical Therapy LLC or one of its affiliated individuals and organizations to participate in these activities, I hereby agree that I, my assignees, heirs, distributes, guardians and legal representatives voluntarily release for liability and forever discharge Range Day Tactical Therapy LLC and its officers, directors and shareholders, for any injury or damages including such injuries or damages from negligent acts, other acts, or omissions howsoever caused by an agent, employee or contractor of Range Day Tactical Therapy LLC. I hereby release and forever discharge Range Day Tactical Therapy LLC from any and all causes of actions, claims, demands or attachment of property that I, my assignees, heirs, distributes, guardians and legal representatives now have or may have for injury or damage resulting from my participation in this activity, even if said actions, claims, demands or attachments are as a result of acts of negligence, other acts, or omissions howsoever caused by Range Day Tactical Therapy LLC. By signing, I understand, agree with and verify these statements to be true.

 

Hold Harmless 

I agree to indemnify and hold harmless Range Day Tactical Therapy LLC from any and all actions, claims, demands, attachments, damages, expenses, harm or distractions suffered or accrued by me or anyone else which may result from my participation in the use of firearms or otherwise using the premises owned, leased or rented by Range Day Tactical Therapy LLC or by myself during participation in this activity, even if said actions, claims, demands or attachments are as a result of acts of negligence, other acts, or omissions howsoever caused by Range Day Tactical Therapy LLC. Should Range Day Tactical Therapy LLC or anyone acting on their behalf incur attorneys fees or costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs. By signing, I understand, agree with and verify these statements to be true.

 

Financial Ability to Cover Injury or Damage 

I certify that I have adequate insurance to cover any injury or damage that I may cause or suffer while participating in this activity, or else I agree to bear the cost of such injury or damage myself. I further certify that I have no medical condition or physical condition which can interfere with my safety in this activity, or else I am willing to assume and bear all costs of all risks that may be created directly or indirectly by such a condition. I understand, agree with and verify these statements to be true.

 

Arizona Venue 

In the event that I file a lawsuit against Range Day Tactical Therapy LLC, I agree to do so solely in the state of Arizona. I further agree that the substantive law of Arizona shall apply to that action without regard to the conflict of law rules of the state. In the event any legal action becomes necessary to enforce or interpret the terms of this agreement, the parties agree that such action will be brought in the US District Court of the State of Arizona, or in the state courts of Arizona in the county of Maricopa. The parties hereby submit to the jurisdiction of said courts.

 

Pictures/Videos and Recordings 

I agree that Range Day Tactical Therapy LLC may tape and photograph me, record my voice and conversations and sound including any performance of any musical compositions during and in connection with my appearance, and that Range Day Tactical Therapy LLC shall be the exclusive owner of the results and proceeds of such taping, photography and recording with the right, throughout the world, and in an unlimited number of times in perpetuity, to copyright, to use and license others to use, in any manner and in all media, all or any portion thereof or a reproduction thereof. I expressly release Range Day Tactical Therapy LLC agents, employees, licensees and assigns from and against any and all claims which I have or may have for invasion of privacy, right of publicity, defamation, copyright infringement, or any other causes of action arising out of the use, adaptation, reproduction, distribution, broadcast or exhibition of the items described in the authorization release.

 

Rights Waived 

By signing this document, I acknowledge that if anyone is injured or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against Range Day Tactical Therapy LLC on the basis of any claim from which I have released Range Day Tactical Therapy LLC herein.

 

Complete Understanding 

I have read, understand and freely give my consent and approval to this “Participation Agreement, Acknowledgement of Risk and Release of Liability” and direct my parents, spouse, children, relatives, heirs, and their legal representatives to strictly adhere to and abide by this agreement both now and in the future. I further acknowledge that this document is a release of liability and a binding contract between myself and Range Day Tactical Therapy LLC. I have signed this document of my own free will and agree to be bound by the terms. I further acknowledge receiving a copy of this agreement if I have requested one.

 

Severability in Even or Partial Invalidity 

If any provision of this Agreement is held in a whole or in part to be unenforceable for any reason, the remainder of that provision and of the entire agreement will be severable and remain in effect.

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Do you acknowledge that the use of firearms is an inherently dangerous activity and choose to freely participate despite the associated risks?*
No
Yes
Have you read and do you understand the range safety rules and their importance?*
No
Yes
Are you under the influence of any substance?*
No
Yes
Are you a prohibited possessor of firearms?*
No
Yes
Do you have any physical or mental impairment that would affect your ability to understand instructions or safety rules?*
No
Yes
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 acknowledge that the use of firearms is an inherently dangerous activity and choose to freely participate despite the associated risks?*
No
Yes
Have you read and do you understand the range safety rules and their importance?*
No
Yes
Are you under the influence of any substance?*
No
Yes
Are you a prohibited possessor of firearms?*
No
Yes
Do you have any physical or mental impairment that would affect your ability to understand instructions or safety rules?*
No
Yes
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Do you acknowledge that the use of firearms is an inherently dangerous activity and choose to freely participate despite the associated risks?*
No
Yes
Have you read and do you understand the range safety rules and their importance?*
No
Yes
Are you under the influence of any substance?*
No
Yes
Are you a prohibited possessor of firearms?*
No
Yes
Do you have any physical or mental impairment that would affect your ability to understand instructions or safety rules?*
No
Yes
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Do you acknowledge that the use of firearms is an inherently dangerous activity and choose to freely participate despite the associated risks?*
No
Yes
Have you read and do you understand the range safety rules and their importance?*
No
Yes
Are you under the influence of any substance?*
No
Yes
Are you a prohibited possessor of firearms?*
No
Yes
Do you have any physical or mental impairment that would affect your ability to understand instructions or safety rules?*
No
Yes
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Do you acknowledge that the use of firearms is an inherently dangerous activity and choose to freely participate despite the associated risks?*
No
Yes
Have you read and do you understand the range safety rules and their importance?*
No
Yes
Are you under the influence of any substance?*
No
Yes
Are you a prohibited possessor of firearms?*
No
Yes
Do you have any physical or mental impairment that would affect your ability to understand instructions or safety rules?*
No
Yes
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Do you acknowledge that the use of firearms is an inherently dangerous activity and choose to freely participate despite the associated risks?*
No
Yes
Have you read and do you understand the range safety rules and their importance?*
No
Yes
Are you under the influence of any substance?*
No
Yes
Are you a prohibited possessor of firearms?*
No
Yes
Do you have any physical or mental impairment that would affect your ability to understand instructions or safety rules?*
No
Yes
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Do you acknowledge that the use of firearms is an inherently dangerous activity and choose to freely participate despite the associated risks?*
No
Yes
Have you read and do you understand the range safety rules and their importance?*
No
Yes
Are you under the influence of any substance?*
No
Yes
Are you a prohibited possessor of firearms?*
No
Yes
Do you have any physical or mental impairment that would affect your ability to understand instructions or safety rules?*
No
Yes
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Do you acknowledge that the use of firearms is an inherently dangerous activity and choose to freely participate despite the associated risks?*
No
Yes
Have you read and do you understand the range safety rules and their importance?*
No
Yes
Are you under the influence of any substance?*
No
Yes
Are you a prohibited possessor of firearms?*
No
Yes
Do you have any physical or mental impairment that would affect your ability to understand instructions or safety rules?*
No
Yes
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Do you acknowledge that the use of firearms is an inherently dangerous activity and choose to freely participate despite the associated risks?*
No
Yes
Have you read and do you understand the range safety rules and their importance?*
No
Yes
Are you under the influence of any substance?*
No
Yes
Are you a prohibited possessor of firearms?*
No
Yes
Do you have any physical or mental impairment that would affect your ability to understand instructions or safety rules?*
No
Yes
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Do you acknowledge that the use of firearms is an inherently dangerous activity and choose to freely participate despite the associated risks?*
No
Yes
Have you read and do you understand the range safety rules and their importance?*
No
Yes
Are you under the influence of any substance?*
No
Yes
Are you a prohibited possessor of firearms?*
No
Yes
Do you have any physical or mental impairment that would affect your ability to understand instructions or safety rules?*
No
Yes
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, 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*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Do you acknowledge that the use of firearms is an inherently dangerous activity and choose to freely participate despite the associated risks?*
No
Yes
Have you read and do you understand the range safety rules and their importance?*
No
Yes
Are you under the influence of any substance?*
No
Yes
Are you a prohibited possessor of firearms?*
No
Yes
Do you have any physical or mental impairment that would affect your ability to understand instructions or safety rules?*
No
Yes
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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