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This is a liability waiver required to shoot outside on the preserve. This waiver must be completed regardless of you shooting or just observing.

I, on my own behalf and that of my heirs, successors, representatives, administrators and assigns hereby:

Waive and completely release any and all past; present or future claims, cause of action, suits, right, damages, costs, expenses or obligations or demands of any kind whatsoever, I, or anyone on my behalf might have against Peace Dale Shooting Preserve, its parent affilates, subsidiaries or successor and their respective officers, directors, servants, employees, agents, representatives and contractors (together Peace Dale Shooting Preserve), for any loss, damage, personal injury, death and/or loss or damage to my property resulting from my participation in such shooting activites; Agree to indemnify, defend and hold harmless Peace Dale Shooting Preserve from any and all claims by any person, firm, corporation or others, for any damages, loss or claims, of any nature, arising in any way out of my participation in such shooting activities.

I Agree

Please select who will be participating...
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First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Agreements
I wish to engage in firearms shooting at Peace Dale Shooting Preserve*
I disagree
I agree
I understand that engaging in these activities may be hazardous, with accompanying risks of personal injury, death, and/or loss or damage to my property. In consideration of my participation in such shooting activities.*
I disagree
I agree
I assume all risks associated with such activities and all responsibility for medical expenses, costs and/or other obligations and other loses or injuries to me in which I may become involved, by reason of my participation in such shooting activities at Peace Dale Shooting Preserve.*
I disagree
I agree
Is this your first time shooting?*
No
No, but I have shot less than 5 times
Yes
Are you under 18 years of age?*
No
Yes
Are you a fugitive from justice?*
No
Yes
Are you a unlawful user of, or addicted to any depressant, stimulant, narcotic or controlled substance including marijuana?*
No
Yes
Have you or will you consume(d) any alcohol, marijuana, narcotics or stimulants prior to arriving at or while at the facility? Understand that the suspicion or odor of use of the aforementioned substances will prevent entry to the facility.*
No
Yes
Have you been convicted in any court of a crime punishable by imprisonment for a term exceeding 1 year, even if you were given a shorter sentence?*
No
Yes
Have you ever been charged with a Felony of any kind, misdemeanor crime of domestic violence, or firearms crime of any kind?*
No
Yes
Have you ever been adjudicated mentally defective or committed to a mental institution?*
No
Yes
Have you ever been convicted in any court of a misdemeanor crime of domestic violence?*
No
Yes
Are you subject to a court order restraining you from harassing, stalking, or threatening a domestic partner or child of a domestic partner?*
No
Yes

Upon signing this Peace Dale Shooting waiver, I hereby declare I have read, understand, and will abide by this agreement and Peace Dale Shooting Preserve's Rules.

First Participant's Signature*
Parent or Guardian's Email Address

Email*

Confirm Email*
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How did you find out about our range?
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 Agreements
I wish to engage in firearms shooting at Peace Dale Shooting Preserve*
I disagree
I agree
I understand that engaging in these activities may be hazardous, with accompanying risks of personal injury, death, and/or loss or damage to my property. In consideration of my participation in such shooting activities.*
I disagree
I agree
I assume all risks associated with such activities and all responsibility for medical expenses, costs and/or other obligations and other loses or injuries to me in which I may become involved, by reason of my participation in such shooting activities at Peace Dale Shooting Preserve.*
I disagree
I agree
Is this your first time shooting?*
No
No, but I have shot less than 5 times
Yes
Are you under 18 years of age?*
No
Yes
Are you a fugitive from justice?*
No
Yes
Are you a unlawful user of, or addicted to any depressant, stimulant, narcotic or controlled substance including marijuana?*
No
Yes
Have you or will you consume(d) any alcohol, marijuana, narcotics or stimulants prior to arriving at or while at the facility? Understand that the suspicion or odor of use of the aforementioned substances will prevent entry to the facility.*
No
Yes
Have you been convicted in any court of a crime punishable by imprisonment for a term exceeding 1 year, even if you were given a shorter sentence?*
No
Yes
Have you ever been charged with a Felony of any kind, misdemeanor crime of domestic violence, or firearms crime of any kind?*
No
Yes
Have you ever been adjudicated mentally defective or committed to a mental institution?*
No
Yes
Have you ever been convicted in any court of a misdemeanor crime of domestic violence?*
No
Yes
Are you subject to a court order restraining you from harassing, stalking, or threatening a domestic partner or child of a domestic partner?*
No
Yes

Upon signing this Peace Dale Shooting waiver, I hereby declare I have read, understand, and will abide by this agreement and Peace Dale Shooting Preserve's Rules.

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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