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DISCLAIMER & LIMITATION OF LIABILITY NOTICE

Anyone entering these premises or using any Freedom Firearms LLC d/b/a Pocono Range (hereinafter “Company”) facility does so entirely at their own risk. To the extent not prohibited by law, you agree that in no circumstance shall Company be liable to you (including but not limited to your heirs, executors, agents or assigns) for any loss or damage (including, without limitation, any injury, both physical and emotional arising directly or indirectly from your use or inability to use, any Company facility. All those who enter freely agree to indemnify and hold harmless Company, including its members, shareholders, owners, employees, officers, managers and agents, and the owners of the property.

Company and its subsidiaries have taken commercially reasonable efforts to keep its facilities as safe, secure and clean/sanitized as possible. You acknowledge that regardless of the actions of Company, infectious disease is an inherent risk in any public location where people are present.  Due to the nature of being a public facility, Company takes no responsibility for, and will not be liable for, any potential exposure to infectious diseases beyond its control or for any loss, damage or death suffered as a result of the use or access to its facilities.

RANGE SAFETY RULES

1. No one is allowed on the range under the influence of alcohol or any other controlled substance.

2. No loaded firearms are to enter or exit the building. All magazines and speed loaders must be unloaded. Loaded firearms at firing line only. No firearms are permitted in the store area without being in a container.

3. Firearms may be inspected at the check-in counter at the request of Company staff. Any firearms or ammunition found to be unsafe or unserviceable will not be allowed onto the range.

4. All handguns, rifles and shotguns are subject to approval.

5. Two adult shooters are allowed per lane. No spectators allowed in the shooting bay. All persons entering the range will be charged accordingly.

6. Eye and ear protection must be worn at ALL TIMES on the range.

7. Unauthorized targets are not permitted on the range. Minimum size for targets is 24” x 21”. Shooting at anything other than your own target is strictly prohibited.

8. No head shots for inexperienced shooters. Shots must be a minimum of 15” below the target hangers.

9. Wearing or drawing from a holster is only permitted for Company approved members who have passed an efficiency test with a Company representative/Range Officer.

10. The muzzle of all firearms must be kept pointed downrange at all times. If leaving the range temporarily, leave all firearms on the firing line unloaded with the action open and the muzzle pointing downrange. The following gun handling rules must be obeyed at all times:

A. Always keep your gun pointed down range
B. Always keep your finger off the trigger until ready to fire
C. Always keep action open and firearm unloaded until ready to shoot
D. Identify your target and what is behind the target
E. Be sure the firearm is safe to operate
F. Know how to use the gun safely
G. Use only correct ammunition for your specific firearm
H. Unload, open the action, remove the magazine and bench all firearms during a cease-fire

11. All firearms must arrive and leave the range in a case. No uncased firearms may leave the shooting booth area.

12. If a misfire or other malfunction occurs, keep the firearm pointed downrange and signal the range staff. Place the firearm on the bench pointed downrange and obtain assistance. DO NOT leave the firing line with a loaded or jammed firearm.

13. All ammunition is subject to inspection and approval. Allowable calibers are: Handguns, .22 rimfire through .50 caliber. Rifles that are chambered for handgun ammunition or .223 through .308 caliber. NO PISTOLS THAT ARE CHAMBERED FOR RIFLE CARTRIDGES unless approved by a Company representative/Range Officer and must be used in the intended configuration. ABSOLUTELY NO STEEL CORE AMMUNITION IS ALLOWED. ABSOLUTELY NO TRACER AMMUNITION IS ALLOWED!! Shotguns: SLUG AND BUCKSHOT ONLY. Shotguns are to be fired from the shoulder only. NO STEEL SHOT IS ALLOWED. SHOTGUNS WITH ONLY PISTOL GRIPS ARE NOT ALLOWED.

14. Company and its staff shall not be held liable for any damages incurred from use of ammunition. Customer will resolve any issues with the manufacturer of the product.

15. No fast or rapid firing allowed except for members who have passed an efficiency test with a Company representative/Range Officer. Allow at least 3 seconds between shots. Any hazardous behavior WILL RESULT IN IMMEDIATE DISMISSAL FROM THE PREMISES.

16. Comply with all instructions from the range staff.

17. Report any unsafe conduct to the range staff immediately.

18. Any brass being removed from the range must be marked. Please notify the cashier during check-in.

19. Any violation of range safety rules will result in IMMEDIATE REPRIMAND and possible DISMISSAL from the range.

20. Only ammunition purchased at Company will be allowed for rental firearms.

21. THERE WILL BE NO REFUNDS OF ANY KIND FOR PARTIES EXPELLED FROM THE RANGE FOR SAFETYVIOLATIONS.

 

I agree that I have watched the safety video in its entirety,

I HAVE READ AND UNDERSTAND THE ABOVE RANGE SAFETY RULES. AT ALL TIMES I WILL FULLY COMPLY WITH ALL OF THE ABOVE RANGE SAFETY RULES. Company’ RANGE SAFETY RULES ARE SUBJECT TO CHANGE.

                                                      

 

RELEASE, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

The terms and conditions of this agreement applies to all shooting ranges owned and operated by FREEDOM FIREARMS LLC (hereinafter the “Company”).

In consideration of being allowed to enter or use the facilities, including but not limited to the shooting range located at 85 N. 1st St, Stroudsburg PA 18360 (all of which are hereinafter referred to as the “Facilities”) and participate in the activities of Company, I hereby agree to each of the following terms and conditions of this Agreement, and I have initialed each as having been read and understood by me:

1. I have read the Range Safety Rules and I understand these Range Rules may be amended from time to time and that I am responsible for reviewing the posted Range Rules when I use the Company Facilities. I verify that, before using the Facilities, I either have watched or will watch the Company safety presentation. I agree to obey and comply with the Range Rules, general policies and rules of operation and administration of Company.

2. I am familiar with and understand the operation of each firearm (rifle, handgun, or long gun) which I will use at Company. The word “operation” includes the safe handling, loading and unloading procedures, and safety mechanisms and features of each firearm.

3. I understand that Company suggests the use of newly manufactured commercial ammunition at all times on Company ranges. I accept full and complete responsibility for the inherent risks resulting from my and anyone else’s use of factory ammunition and/or reloads or handloads, including all responsibility for personal injuries to myself and anyone else. I also agree to thoroughly check to be sure I am using the correct ammunition at all times.

4. I agree that prior to participating in or observing any shooting activities, I will inspect the Facilities, firearms and ammunition to be used and, if I believe anything to be unsafe for any reason, I will so advise a Range Officer and will leave the unsafe portion of the Facilities immediately.

5. I acknowledge and fully understand that I and all others engaged in shooting, coaching, observing or training with firearms at Company facilities will be engaged in activities that involve inherent risks of serious personal injury including disability or death and severe social and economic losses which might result from my actions or inactions or the actions or inactions of others including but not limited to:

A. My failure to abide by firearms safety rules or to properly handle or use firearms or ammunition;
B. The failure of others to abide by firearms safety rules or to properly handle or use firearms or ammunition;
C. The characteristics, including the design, manufacturing or other defects, of any firearm or ammunition being used by myself or others at Company facilities;
D. The characteristics, including the design, construction, and/or care and maintenance, of Company’s facilities including, but not limited to, the multiple firing point ranges; and
E. The inability of Company personnel (including Range Officers) to, at all times, monitor or supervise members, their guests, hourly fee users and others using the Company Facilities including said ranges.

6. I agree for myself, my heirs, executors, administrators and assigns to accept the risk of my actions or inactions or the actions or inactions of others, including but not limited to the above

7. I recognize that I may be expelled from the Facilities for violation of the Range Rules or for behavior deemed unsafe by Company personnel. Decisions regarding expulsion are final.

8. I accept full responsibility for and agree to indemnify Company for any damage or destruction I cause to Company property, whether accidental, negligent, willful or otherwise. Company property includes, but is not limited to, the Facility, range equipment, target frames, target supports or mechanisms, firearms, signs, and all equipment, electrical and otherwise. Company reserves the right to recover from me a reasonable charge for any such damage and is entitled to recover its costs, including reasonable attorneys’ fees, incurred in bringing any claim for such damage.

9. On behalf of myself, my heirs, executors, administrators and assigns, I hereby assume all risk of personal injury, including disability or death including but not limited to, physical and emotional injury of any kind, loss of physical function, ability or capacity, medical expenses, lost wages or income, loss of consortium and any other compensatory damage.

10. On behalf of myself, my heirs, executors, administrators and assigns, I hereby waive, release and discharge Company LLC,  its affiliates and there subsidiaries as well as BLUE ASSETS LLC (Landlord of Freedom Firearms LLC) and each of their officers, directors, owners (members), managers, employees, agents, successors and assigns (“Released Parties”) from any and all claims, demands, actions or lawsuits seeking damages on account of any personal injury, disability or death occurring to myself or anyone else, caused in whole or in part or alleged to be so caused by the negligence of any of the Released Parties or caused by anyone else.

11. On behalf of myself, my heirs, executors, administrators and assigns, I hereby agree to indemnify and defend the Released Parties from any and all claims, demands, actions or lawsuits for any personal injury, disability or death occurring to myself or any other person which result entirely or in part from the actions, failure to act, or negligence of myself, my guests or minors for whom I am responsible.

12. I agree that this Release, Assumption of Risk and Indemnity Agreement shall be interpreted according to Pennsylvania law and that any dispute shall be resolved exclusively in the courts of the Commonwealth of Pennsylvania or federal courts having jurisdiction over matters occurring in the location of the Facilities.

13. Membership at the Company facilities will be available to persons who are legally able to possess a firearm and are over the age of 18. Members must be in compliance at all times with all federal, state and local laws and regulations concerning ownership and handling of firearms. Membership will be granted, and may be revoked, at the sole discretion of the Company.

14. I certify as follows: (1) I am not currently and have never been the subject of a criminal or any other proceeding that prevents me from legally owning, handling or possessing firearms under Pennsylvania or Federal law; (2) that I can lawfully own, handle and possess a firearm; and (3) that all information given in this application is true and correct to the best of my knowledge.

15. I am NOT an unlawful user of, or addicted to, marijuana or any depressant, stimulant, or narcotic drug or any other controlled substance.

16. In the event I bring a minor to any Company facility, the attached Guardian’s Release has been signed by the minor’s legal guardian and I confirm the minor is over the age of 10.

17. I recognize the safety of everyone at Company facilities is my responsibility and I agree not to cause harm to myself or others at Company facilities.

18. I recognize that if I do anything while using the Facilities (including in any of the parking areas of the Facility) to in any way intentionally cause personal injury (including death) to myself or that may intentionally or negligently cause personal injury (including death) to any third party or any property owned by any third party (including Company), the Company shall have the right to bring a claim against me and/or my heirs, executors, administrators and assigns to recover damage caused both to any property of Company and to the business of Company as a result of such acts.

19. I hereby recognize and acknowledge that by signing this document I have read, understand and will abide by the Range Safety Rules and that failure to abide by the Safety Rules established by Company could result in temporary or permanent ejection from the range and facility.

20. By signing this document, I acknowledge the NRA recommendation to avoid recreational/training shooting during pregnancy. I accept the risk to my (our) fetus if I (we) choose to enter the range, whether planning to shoot or observe. (Note: medical article available at Range Desk to document reasons for this recommendation.)

21. I acknowledge that I am providing my valid email address and mobile phone number to Company. I consent to receive recurring SMS messages and understand Standard Msg & data rates apply.  I consent to receive information about promotions and sales.  I understand that I may later opt-out of non-essential communication by notice to Company. My signature below gives Company permission to contact me via mobile or email for any necessary follow up and/or to provide updates and promotions.

22. By Signing this Agreement, I do hereby swear, affirm or attest that:

A. I am legally allowed to possess a firearm in this jurisdiction (being Pennsylvania and the United States)
B. I am not currently the subject of either a criminal, domestic protection or civil restraining order. 
C. I am not under a felony indictment in any court, nor have i ever been convicted of a felony as an adult or juvenile. 
D. I am not a fugitive from justice. 
E. I am not an unlawful user of, or addicted to any controlled substance. 
F. I have never been adjudicated as mentally defective or incompetent to manage my own affairs. 
G. I have never been discharged from the United States Armed Forces under dishonorable conditions. 
H. I am a citizen or legal resident of the United States or if I am a foreign national, I am not a  prohibited person for possessing firearms and ammunition under the provisions of 27 CFR 178.97 relating to non-immigrant aliens unless I meet any ONE of the following exceptions in section 922(y)(2) of the GCA being:

  • I possess a valid and unexpired hunting license or permit lawfully issued by the Federal Government, a State, or local government, or an Indian tribe federally recognized by the Bureau of Indian Affairs.
  • I am currently admitted to the United States for lawful hunting or sporting purposes
  • I am an official representative of a foreign government who is accredited to the United States Government or the Government’s mission to an international organization having its headquarters in the United States.
  • I am an official of a foreign government or are designated as a distinguished foreign visitor by the Department of State, or
  • I am a foreign law enforcement officer of a friendly foreign government entering the United States on official law enforcement business.
  • I have received a waiver issued by the Attorney General of the United States or Department of Justice and obtaining approval under section 922(y)(3).
  • I am a permanent resident alien, or an alien lawfully admitted to the U.S. without a visa (e.g. Visa Waiver Program) and do not fall within the prohibition.


In consideration for being given access to the Company facility and/or equipment, the undersigned, for himself or herself and his or her heirs, executors and administrators, releases, waives, discharges and covenants not to sue the Company and each of its members, officers, managers, employees and agents for any and all liability, claims, demands, actions and causes of action whatsoever for personal injury or property damage arising out of the use of that equipment and/or facilities for any and all claims, demands, actions and causes of action for personal injury or property damage, loss or injury, including death, that may be sustained by the undersigned, whether caused by the negligence of the Releases or otherwise, arising out of all such use. I acknowledge that as a condition to the Company allowing me to access the Company facilities and/or equipment, I will also be required to sign and deliver to the Company the Adult Release, Assumption of Risk and Indemnity Agreement.

I hereby verify and confirm that I, the actual signer of this Agreement, am an adult over the age of 18 years, that I have read and agree to each of the above terms and conditions, that I understand everything set forth above that all statements verified herein are true and correct, and that I have knowingly given up substantial legal rights by signing below, which I do voluntarily.

 

PARENTS(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.

In consideration for being given access to the Company facility and/or equipment, the undersigned, for the minor participants listed below, the minor’s heirs, executors and administrators, releases, waives, discharges and covenants not to sue the Company and each of its members, officers, managers, employees and agents for any and all liability, claims, demands, actions and causes of action whatsoever for personal injury or property damage arising out of the use of that equipment and/or facilities for any and all claims, demands, actions and causes of action for personal injury or property damage, loss or injury, including death, that may be sustained by the undersigned, whether caused by the negligence of the Releases or otherwise, arising out of all such use. I acknowledge that as a condition to the Company allowing me to access the Company facilities and/or equipment, I will also be required to sign and deliver to the Company the Adult Release, Assumption of Risk and Indemnity Agreement.

I hereby verify and confirm that I, the actual signer of this Agreement, am an adult over the age of 18 years, that I have read and agree to each of the above terms and conditions on behalf of each minor listed below, that I am authorized to do so and that I understand everything set forth above and have executed the same with knowledge and complete understanding.  As the signer hereof, I agree that I shall be legally and financially liable and responsible under this agreement for all actions or inactions of the minor(s) listed below.

 

Date: March 5, 2021                                                                                                                                                                                          

 

 

 
First Participant's Name

First Name*

Middle Name

Last Name*

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

FIREARMS EXPERIENCE AND RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, or any other facility owned and operated by FREEDOM FIREARM LLC, FREEDOM FIREARMS II LLC, FREEDOM FIREARMS III DEFENSE TRAINING SOLUTIONS LLC (hereinafter "the Company"), whether using their own or rental firearms MUST completely fill out this form. All information supplied will be kept strictly confidential, not distributed or made available to the others for any purpose and is for the sole use by the Company to properly identify the user, and to document their previous firearms experience. This is done to best ensure the safety of all range users.

I would rate my previous experience with firearms as (please check as applicable):

Handgun *
Novice
Beginner
Intermediate
Expert
Rifle
Novice
Beginner
Intermediate
Expert
Shotgun
Novice
Beginner
Intermediate
Expert
Have you. Ever been adjudicated as mentally defective, been committed to mental institution, or have a history of mental illness?*
No
Yes
Are you a user of, addicted to, marijuana, or any depressant, stimulant or narcotic drug, or any other controlled substance?*
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

FIREARMS EXPERIENCE AND RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, or any other facility owned and operated by FREEDOM FIREARM LLC, FREEDOM FIREARMS II LLC, FREEDOM FIREARMS III DEFENSE TRAINING SOLUTIONS LLC (hereinafter "the Company"), whether using their own or rental firearms MUST completely fill out this form. All information supplied will be kept strictly confidential, not distributed or made available to the others for any purpose and is for the sole use by the Company to properly identify the user, and to document their previous firearms experience. This is done to best ensure the safety of all range users.

I would rate my previous experience with firearms as (please check as applicable):

Handgun *
Novice
Beginner
Intermediate
Expert
Rifle
Novice
Beginner
Intermediate
Expert
Shotgun
Novice
Beginner
Intermediate
Expert
Have you. Ever been adjudicated as mentally defective, been committed to mental institution, or have a history of mental illness?*
No
Yes
Are you a user of, addicted to, marijuana, or any depressant, stimulant or narcotic drug, or any other controlled substance?*
No
Yes
Third Participant's Name

First Name*

Middle Name

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

FIREARMS EXPERIENCE AND RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, or any other facility owned and operated by FREEDOM FIREARM LLC, FREEDOM FIREARMS II LLC, FREEDOM FIREARMS III DEFENSE TRAINING SOLUTIONS LLC (hereinafter "the Company"), whether using their own or rental firearms MUST completely fill out this form. All information supplied will be kept strictly confidential, not distributed or made available to the others for any purpose and is for the sole use by the Company to properly identify the user, and to document their previous firearms experience. This is done to best ensure the safety of all range users.

I would rate my previous experience with firearms as (please check as applicable):

Handgun *
Novice
Beginner
Intermediate
Expert
Rifle
Novice
Beginner
Intermediate
Expert
Shotgun
Novice
Beginner
Intermediate
Expert
Have you. Ever been adjudicated as mentally defective, been committed to mental institution, or have a history of mental illness?*
No
Yes
Are you a user of, addicted to, marijuana, or any depressant, stimulant or narcotic drug, or any other controlled substance?*
No
Yes
Fourth Participant's Name

First Name*

Middle Name

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

FIREARMS EXPERIENCE AND RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, or any other facility owned and operated by FREEDOM FIREARM LLC, FREEDOM FIREARMS II LLC, FREEDOM FIREARMS III DEFENSE TRAINING SOLUTIONS LLC (hereinafter "the Company"), whether using their own or rental firearms MUST completely fill out this form. All information supplied will be kept strictly confidential, not distributed or made available to the others for any purpose and is for the sole use by the Company to properly identify the user, and to document their previous firearms experience. This is done to best ensure the safety of all range users.

I would rate my previous experience with firearms as (please check as applicable):

Handgun *
Novice
Beginner
Intermediate
Expert
Rifle
Novice
Beginner
Intermediate
Expert
Shotgun
Novice
Beginner
Intermediate
Expert
Have you. Ever been adjudicated as mentally defective, been committed to mental institution, or have a history of mental illness?*
No
Yes
Are you a user of, addicted to, marijuana, or any depressant, stimulant or narcotic drug, or any other controlled substance?*
No
Yes
Fifth Participant's Name

First Name*

Middle Name

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

FIREARMS EXPERIENCE AND RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, or any other facility owned and operated by FREEDOM FIREARM LLC, FREEDOM FIREARMS II LLC, FREEDOM FIREARMS III DEFENSE TRAINING SOLUTIONS LLC (hereinafter "the Company"), whether using their own or rental firearms MUST completely fill out this form. All information supplied will be kept strictly confidential, not distributed or made available to the others for any purpose and is for the sole use by the Company to properly identify the user, and to document their previous firearms experience. This is done to best ensure the safety of all range users.

I would rate my previous experience with firearms as (please check as applicable):

Handgun *
Novice
Beginner
Intermediate
Expert
Rifle
Novice
Beginner
Intermediate
Expert
Shotgun
Novice
Beginner
Intermediate
Expert
Have you. Ever been adjudicated as mentally defective, been committed to mental institution, or have a history of mental illness?*
No
Yes
Are you a user of, addicted to, marijuana, or any depressant, stimulant or narcotic drug, or any other controlled substance?*
No
Yes
Sixth Participant's Name

First Name*

Middle Name

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

FIREARMS EXPERIENCE AND RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, or any other facility owned and operated by FREEDOM FIREARM LLC, FREEDOM FIREARMS II LLC, FREEDOM FIREARMS III DEFENSE TRAINING SOLUTIONS LLC (hereinafter "the Company"), whether using their own or rental firearms MUST completely fill out this form. All information supplied will be kept strictly confidential, not distributed or made available to the others for any purpose and is for the sole use by the Company to properly identify the user, and to document their previous firearms experience. This is done to best ensure the safety of all range users.

I would rate my previous experience with firearms as (please check as applicable):

Handgun *
Novice
Beginner
Intermediate
Expert
Rifle
Novice
Beginner
Intermediate
Expert
Shotgun
Novice
Beginner
Intermediate
Expert
Have you. Ever been adjudicated as mentally defective, been committed to mental institution, or have a history of mental illness?*
No
Yes
Are you a user of, addicted to, marijuana, or any depressant, stimulant or narcotic drug, or any other controlled substance?*
No
Yes
Seventh Participant's Name

First Name*

Middle Name

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

FIREARMS EXPERIENCE AND RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, or any other facility owned and operated by FREEDOM FIREARM LLC, FREEDOM FIREARMS II LLC, FREEDOM FIREARMS III DEFENSE TRAINING SOLUTIONS LLC (hereinafter "the Company"), whether using their own or rental firearms MUST completely fill out this form. All information supplied will be kept strictly confidential, not distributed or made available to the others for any purpose and is for the sole use by the Company to properly identify the user, and to document their previous firearms experience. This is done to best ensure the safety of all range users.

I would rate my previous experience with firearms as (please check as applicable):

Handgun *
Novice
Beginner
Intermediate
Expert
Rifle
Novice
Beginner
Intermediate
Expert
Shotgun
Novice
Beginner
Intermediate
Expert
Have you. Ever been adjudicated as mentally defective, been committed to mental institution, or have a history of mental illness?*
No
Yes
Are you a user of, addicted to, marijuana, or any depressant, stimulant or narcotic drug, or any other controlled substance?*
No
Yes
Eighth Participant's Name

First Name*

Middle Name

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

FIREARMS EXPERIENCE AND RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, or any other facility owned and operated by FREEDOM FIREARM LLC, FREEDOM FIREARMS II LLC, FREEDOM FIREARMS III DEFENSE TRAINING SOLUTIONS LLC (hereinafter "the Company"), whether using their own or rental firearms MUST completely fill out this form. All information supplied will be kept strictly confidential, not distributed or made available to the others for any purpose and is for the sole use by the Company to properly identify the user, and to document their previous firearms experience. This is done to best ensure the safety of all range users.

I would rate my previous experience with firearms as (please check as applicable):

Handgun *
Novice
Beginner
Intermediate
Expert
Rifle
Novice
Beginner
Intermediate
Expert
Shotgun
Novice
Beginner
Intermediate
Expert
Have you. Ever been adjudicated as mentally defective, been committed to mental institution, or have a history of mental illness?*
No
Yes
Are you a user of, addicted to, marijuana, or any depressant, stimulant or narcotic drug, or any other controlled substance?*
No
Yes
Ninth Participant's Name

First Name*

Middle Name

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

FIREARMS EXPERIENCE AND RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, or any other facility owned and operated by FREEDOM FIREARM LLC, FREEDOM FIREARMS II LLC, FREEDOM FIREARMS III DEFENSE TRAINING SOLUTIONS LLC (hereinafter "the Company"), whether using their own or rental firearms MUST completely fill out this form. All information supplied will be kept strictly confidential, not distributed or made available to the others for any purpose and is for the sole use by the Company to properly identify the user, and to document their previous firearms experience. This is done to best ensure the safety of all range users.

I would rate my previous experience with firearms as (please check as applicable):

Handgun *
Novice
Beginner
Intermediate
Expert
Rifle
Novice
Beginner
Intermediate
Expert
Shotgun
Novice
Beginner
Intermediate
Expert
Have you. Ever been adjudicated as mentally defective, been committed to mental institution, or have a history of mental illness?*
No
Yes
Are you a user of, addicted to, marijuana, or any depressant, stimulant or narcotic drug, or any other controlled substance?*
No
Yes
Tenth Participant's Name

First Name*

Middle Name

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

FIREARMS EXPERIENCE AND RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, or any other facility owned and operated by FREEDOM FIREARM LLC, FREEDOM FIREARMS II LLC, FREEDOM FIREARMS III DEFENSE TRAINING SOLUTIONS LLC (hereinafter "the Company"), whether using their own or rental firearms MUST completely fill out this form. All information supplied will be kept strictly confidential, not distributed or made available to the others for any purpose and is for the sole use by the Company to properly identify the user, and to document their previous firearms experience. This is done to best ensure the safety of all range users.

I would rate my previous experience with firearms as (please check as applicable):

Handgun *
Novice
Beginner
Intermediate
Expert
Rifle
Novice
Beginner
Intermediate
Expert
Shotgun
Novice
Beginner
Intermediate
Expert
Have you. Ever been adjudicated as mentally defective, been committed to mental institution, or have a history of mental illness?*
No
Yes
Are you a user of, addicted to, marijuana, or any depressant, stimulant or narcotic drug, or any other controlled substance?*
No
Yes
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

Emergency Contact's Name*

Emergency Contact's Phone Number*

Driver's License or passport # *

Issuing Authority: *

Issue Date: *

Exp. Date: *

If you are an alien, record your US issued Alien or administration Number (AR#, USCIS#, or I94#)

How did you hear about us? *
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 Information

FIREARMS EXPERIENCE AND RANGE SAFETY QUESTIONNAIRE

Everyone who wishes to shoot in this facility, or any other facility owned and operated by FREEDOM FIREARM LLC, FREEDOM FIREARMS II LLC, FREEDOM FIREARMS III DEFENSE TRAINING SOLUTIONS LLC (hereinafter "the Company"), whether using their own or rental firearms MUST completely fill out this form. All information supplied will be kept strictly confidential, not distributed or made available to the others for any purpose and is for the sole use by the Company to properly identify the user, and to document their previous firearms experience. This is done to best ensure the safety of all range users.

I would rate my previous experience with firearms as (please check as applicable):

Handgun *
Novice
Beginner
Intermediate
Expert
Rifle
Novice
Beginner
Intermediate
Expert
Shotgun
Novice
Beginner
Intermediate
Expert
Have you. Ever been adjudicated as mentally defective, been committed to mental institution, or have a history of mental illness?*
No
Yes
Are you a user of, addicted to, marijuana, or any depressant, stimulant or narcotic drug, or any other controlled substance?*
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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