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All those who wish to train with Blackout Training Group, LLC in any capacity must complete this form in its entirety.  Any information you provide is confidential and will not be distributed to any third parties.  This waiver is strictly for use by Blackout Training Group, LLC.

Initial Assumption of Risk: I, hereby release Blackout Training Group, LLC., its member entities, owners, employees, officers, directors, volunteers, instructors, guests, agents, and affiliates from all liability for personal injury or property damage through use, in any way, of the facility, its equipment, its firearms, or my own firearm. I agree to indemnify Blackout Training Group, LLC. from responsibility for any claims or demands arising out of such use. I agree to accept and assume any and all risks while training with Blackout Training Group, LLC. I acknowledge and understand that shooting activities are hazardous and involve risks both known and unanticipated. I agree to assume all responsibility of these risks, which could result in damage to property and serious physical or emotional injury, including paralysis or death, to others or myself. Possible known and unknown injuries may include, but are not limited to: being shot or injured in any manner by myself or others, shooting others, partial or total loss of eyesight or hearing, burns, amputation, inhalation or other harmful contact with lead or contaminants, being struck by flying or falling debris or projectiles, disability, and death. I agree to assume all liability for any act, acts, or omission to act, even any negligent, reckless, or criminal act by any other or myself.

Initial Release and Indemnification: I agree that myself and my heirs, guardians, representatives, successors, that myself, and assigns release and forever discharge and agree not to sue Blackout Training Group, LLC. officers, directors, attorneys, agents, employees, contractors, volunteers, and guests. I release and discharge these same parties for any and all claims, demands, damages, expenses, causes of action, attachments of property, or liability of any kind whatsoever that I may have for property damage, personal injury, or death resulting from my entering the premises, using the facilities or equipment, or engaging in or observing shooting and other activities with Blackout Training Group, LLC. and its operations, even if such claims, demands, damages, expenses, causes of action, attachments of property, or liability result from any acts of Blackout Training Group, LLC., even any negligent act or omission to act including negligent or omitted first-aid or rescue operations or procedures. Further, I agree to indemnify, defend, and hold harmless Blackout Training Group, LLC., for any and all claims, damages, demands, causes of action, expenses, attachments of property, attorneys’ fees, court costs, or liability of any kind that any person or entity may have for property damage, personal injury, or death resulting from my entering the premises, using any facilities or equipment, or engaging in or observing shooting and other activities with Blackout Training Group, LLC. and its operations, to the extent that such claims, damages, demands, causes of action, expenses, attachments of property, attorneys’ fees, court costs, or liability result partially or wholly from any negligent act of participant, or any act that would subject participant to strict liability.

Initial Medical Certification: I certify that I have no medical or physical conditions that could compromise my safety and the safety of others in any activities with Blackout Training Group, LLC. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer, or else I agree to personally bear the costs of such injury or damage.

Initial Other Rules: I agree to abide by all written, video, and verbal safety rules issued by Blackout Training Group, LLC. instructors, staff, or Range Safety Officers, and to supply my own safety equipment. I am over 21 years of age by the date of scheduled training/class.

Initial Definition of Firearm: For the purposes of this Agreement, a firearm is defined as any pistol/handgun, rifle, shotgun and/or machine gun or device of any description or design whether single shot, semiautomatic or fully automatic which discharges a projectile by the use of gunpowder or compressed air.

Initial Venue: This Waiver and Release and Indemnity Agreement is governed by the laws of the State of Texas. Venue shall be within the State of Texas.

I have fully and carefully read this Waiver, Release and Indemnity Agreement and understand its contents. I am aware that this is a release from liability and indemnification agreement and a contract between Blackout Training Group, LLC. and myself and that it imposes limitations to my legal rights. I sign it of my own free will. I certify that I will not operate any firearms or equipment with which I am not completely familiar. I also consent to be financially responsible for and reimburse Blackout Training Group, LLC. for any shooting that causes damage.

Photo Release: I grant permission and consent to Blackout Training Group LLC for the use of all photograph(s) and/or video(s) as identified below for presentation under any legal condition, including but not limited to: publicity, copyright purposes, illustration, advertising, and web content:

Description: Any pictures or videos taken during trainings or classes for Blackout Training Group LLC.

Payment  

I understand that there shall be no payment for this release.

Royalties 

I understand that no royalty, fee, or other compensation shall become payable to me by reason of such use.

Revocation   

I understand that with my authorization below the photograph(s) may never be revoked.

 

We, the Releasor and Releasee, understand and agree to the aforementioned terms and conditions.

 

First Participant's Name

First Name*

Middle Name

Last Name*

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Participant's 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's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
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*

Middle Name

Last Name*

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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