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6001 167th Ave. NW

Ramsey, MN 55303

 

Ph: 763-432-6134

 

www.mntotaldefense.com

WAIVER OF LIABILITY RELEASE HOLD HARMLESS AND INDEMNIFICATION AGREEMENT

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 and risk of loss or harm to third parties. In consideration of my participation in such shooting activities, 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, causes of action, suits, rights, damages, costs, expenses or obligations or demands of any kind whatsoever, I, or anyone on my behalf might have against Total Defense, Inc.., its parent, affiliates, subsidiaries or successor and their respective officers, directors, servants, employees, agents, representatives and contractors (together “Total Defense, Inc.), for any loss, damage, personal injury, death and/ or loss or damage to my property resulting from my participation in such shooting activities;
Agree to indemnify, defend and hold harmless Total Defense, Inc., 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; and
Assume all risks associated with such activities and all responsibility for medical expenses, costs and/ or other obligations and other losses or injuries to me or in which I may become involved, by reason of my participation in such shooting activities at the aforementioned facility or event

 

I further certify that I am over eighteen (18) years of age and have read and understand this Waiver of Liability and have executed this instrument voluntarily on this date.

 

MY COMMITMENT TO SAFE GUN HANDLING

Anyone who uses a firearm has a responsibility to themselves and others to use the firearm safely.

I acknowledge that I am familiar with the basic rules of firearm safety and that those basic rules have been explained to me.I agree to follow all of the basic rules of firearm safety at all times during my use and handling of any firearms.

The safe use of firearms dictates that I understand and agree to follow all of these instructions:

I WILL TREAT EVERY FIREARM AS IF IT WERE LOADED.
I WILL ALWAYS KEEP THE FIREARM POINTED IN A SAFE DIRECTION.
I WILL NOT PLACE MY FINGER ON THE TRIGGER OR IN THE TRIGGER GUARD UNLESS AND UNTIL I AM READY TO FIRE.
I WILL ALWAYS WEAR APPROPRIATE EYE AND EAR PROTECTION
I WILL NEVER PASS THE FIREARM TO ANYONE WITHOUT OPENING AND KEEPING OPEN THE CYLINDER OR THE ACTION TO VERIFY THAT IT IS UNLOADED.
I WILL ALWAYS FOLLOW THE COMMANDS OF THE RANGE OFFICER.

       I understand these rules of firearms safety and I agree to follow them at all times.

July 29, 2021                                        

I Agree

 

First Adult Name

First Name*

Last Name*

Phone*
First Adult Date of Birth*
First Adult Background Information
Are you under indictment or information in any court for a felony, or any other crime for which the judge could imprison you for more than one year, or are you a current member of the military who has been charged with violation(s) of the Uniform Code of Military Justice and whose charge(s) have been referred to a general court-martial?*
No
Yes
Have you ever been convicted in any court, including a military court, of a felony, or any other crime for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation?*
No
Yes
Are you a fugitive from justice?*
No
Yes
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.*
No
Yes
Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution?*
No
Yes
Have you ever been convicted in any court of a misdemeanor crime of domestic violence, or are you or have you ever been a member of the military and been convicted of a crime that included, as an element, the use of force against a person as identified in the instructions?*
No
Yes
What is your level of firearm experience?*
None
Beginner
Intermediate
Professional
First Adult Signature*
Second Adult Name

First Name*

Last Name*
Second Adult Date of Birth*
Second Adult Background Information
Are you under indictment or information in any court for a felony, or any other crime for which the judge could imprison you for more than one year, or are you a current member of the military who has been charged with violation(s) of the Uniform Code of Military Justice and whose charge(s) have been referred to a general court-martial?*
No
Yes
Have you ever been convicted in any court, including a military court, of a felony, or any other crime for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation?*
No
Yes
Are you a fugitive from justice?*
No
Yes
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.*
No
Yes
Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution?*
No
Yes
Have you ever been convicted in any court of a misdemeanor crime of domestic violence, or are you or have you ever been a member of the military and been convicted of a crime that included, as an element, the use of force against a person as identified in the instructions?*
No
Yes
What is your level of firearm experience?*
None
Beginner
Intermediate
Professional
Third Adult Name

First Name*

Last Name*
Third Adult Date of Birth*
Third Adult Background Information
Are you under indictment or information in any court for a felony, or any other crime for which the judge could imprison you for more than one year, or are you a current member of the military who has been charged with violation(s) of the Uniform Code of Military Justice and whose charge(s) have been referred to a general court-martial?*
No
Yes
Have you ever been convicted in any court, including a military court, of a felony, or any other crime for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation?*
No
Yes
Are you a fugitive from justice?*
No
Yes
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.*
No
Yes
Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution?*
No
Yes
Have you ever been convicted in any court of a misdemeanor crime of domestic violence, or are you or have you ever been a member of the military and been convicted of a crime that included, as an element, the use of force against a person as identified in the instructions?*
No
Yes
What is your level of firearm experience?*
None
Beginner
Intermediate
Professional
Fourth Adult Name

First Name*

Last Name*
Fourth Adult Date of Birth*
Fourth Adult Background Information
Are you under indictment or information in any court for a felony, or any other crime for which the judge could imprison you for more than one year, or are you a current member of the military who has been charged with violation(s) of the Uniform Code of Military Justice and whose charge(s) have been referred to a general court-martial?*
No
Yes
Have you ever been convicted in any court, including a military court, of a felony, or any other crime for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation?*
No
Yes
Are you a fugitive from justice?*
No
Yes
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.*
No
Yes
Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution?*
No
Yes
Have you ever been convicted in any court of a misdemeanor crime of domestic violence, or are you or have you ever been a member of the military and been convicted of a crime that included, as an element, the use of force against a person as identified in the instructions?*
No
Yes
What is your level of firearm experience?*
None
Beginner
Intermediate
Professional
Fifth Adult Name

First Name*

Last Name*
Fifth Adult Date of Birth*
Fifth Adult Background Information
Are you under indictment or information in any court for a felony, or any other crime for which the judge could imprison you for more than one year, or are you a current member of the military who has been charged with violation(s) of the Uniform Code of Military Justice and whose charge(s) have been referred to a general court-martial?*
No
Yes
Have you ever been convicted in any court, including a military court, of a felony, or any other crime for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation?*
No
Yes
Are you a fugitive from justice?*
No
Yes
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.*
No
Yes
Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution?*
No
Yes
Have you ever been convicted in any court of a misdemeanor crime of domestic violence, or are you or have you ever been a member of the military and been convicted of a crime that included, as an element, the use of force against a person as identified in the instructions?*
No
Yes
What is your level of firearm experience?*
None
Beginner
Intermediate
Professional
Sixth Adult Name

First Name*

Last Name*
Sixth Adult Date of Birth*
Sixth Adult Background Information
Are you under indictment or information in any court for a felony, or any other crime for which the judge could imprison you for more than one year, or are you a current member of the military who has been charged with violation(s) of the Uniform Code of Military Justice and whose charge(s) have been referred to a general court-martial?*
No
Yes
Have you ever been convicted in any court, including a military court, of a felony, or any other crime for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation?*
No
Yes
Are you a fugitive from justice?*
No
Yes
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.*
No
Yes
Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution?*
No
Yes
Have you ever been convicted in any court of a misdemeanor crime of domestic violence, or are you or have you ever been a member of the military and been convicted of a crime that included, as an element, the use of force against a person as identified in the instructions?*
No
Yes
What is your level of firearm experience?*
None
Beginner
Intermediate
Professional
Seventh Adult Name

First Name*

Last Name*
Seventh Adult Date of Birth*
Seventh Adult Background Information
Are you under indictment or information in any court for a felony, or any other crime for which the judge could imprison you for more than one year, or are you a current member of the military who has been charged with violation(s) of the Uniform Code of Military Justice and whose charge(s) have been referred to a general court-martial?*
No
Yes
Have you ever been convicted in any court, including a military court, of a felony, or any other crime for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation?*
No
Yes
Are you a fugitive from justice?*
No
Yes
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.*
No
Yes
Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution?*
No
Yes
Have you ever been convicted in any court of a misdemeanor crime of domestic violence, or are you or have you ever been a member of the military and been convicted of a crime that included, as an element, the use of force against a person as identified in the instructions?*
No
Yes
What is your level of firearm experience?*
None
Beginner
Intermediate
Professional
Eighth Adult Name

First Name*

Last Name*
Eighth Adult Date of Birth*
Eighth Adult Background Information
Are you under indictment or information in any court for a felony, or any other crime for which the judge could imprison you for more than one year, or are you a current member of the military who has been charged with violation(s) of the Uniform Code of Military Justice and whose charge(s) have been referred to a general court-martial?*
No
Yes
Have you ever been convicted in any court, including a military court, of a felony, or any other crime for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation?*
No
Yes
Are you a fugitive from justice?*
No
Yes
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.*
No
Yes
Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution?*
No
Yes
Have you ever been convicted in any court of a misdemeanor crime of domestic violence, or are you or have you ever been a member of the military and been convicted of a crime that included, as an element, the use of force against a person as identified in the instructions?*
No
Yes
What is your level of firearm experience?*
None
Beginner
Intermediate
Professional
Ninth Adult Name

First Name*

Last Name*
Ninth Adult Date of Birth*
Ninth Adult Background Information
Are you under indictment or information in any court for a felony, or any other crime for which the judge could imprison you for more than one year, or are you a current member of the military who has been charged with violation(s) of the Uniform Code of Military Justice and whose charge(s) have been referred to a general court-martial?*
No
Yes
Have you ever been convicted in any court, including a military court, of a felony, or any other crime for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation?*
No
Yes
Are you a fugitive from justice?*
No
Yes
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.*
No
Yes
Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution?*
No
Yes
Have you ever been convicted in any court of a misdemeanor crime of domestic violence, or are you or have you ever been a member of the military and been convicted of a crime that included, as an element, the use of force against a person as identified in the instructions?*
No
Yes
What is your level of firearm experience?*
None
Beginner
Intermediate
Professional
Tenth Adult Name

First Name*

Last Name*
Tenth Adult Date of Birth*
Tenth Adult Background Information
Are you under indictment or information in any court for a felony, or any other crime for which the judge could imprison you for more than one year, or are you a current member of the military who has been charged with violation(s) of the Uniform Code of Military Justice and whose charge(s) have been referred to a general court-martial?*
No
Yes
Have you ever been convicted in any court, including a military court, of a felony, or any other crime for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation?*
No
Yes
Are you a fugitive from justice?*
No
Yes
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.*
No
Yes
Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution?*
No
Yes
Have you ever been convicted in any court of a misdemeanor crime of domestic violence, or are you or have you ever been a member of the military and been convicted of a crime that included, as an element, the use of force against a person as identified in the instructions?*
No
Yes
What is your level of firearm experience?*
None
Beginner
Intermediate
Professional
Parent or Guardian's Email Address

Email*

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

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Background Information
Are you under indictment or information in any court for a felony, or any other crime for which the judge could imprison you for more than one year, or are you a current member of the military who has been charged with violation(s) of the Uniform Code of Military Justice and whose charge(s) have been referred to a general court-martial?*
No
Yes
Have you ever been convicted in any court, including a military court, of a felony, or any other crime for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation?*
No
Yes
Are you a fugitive from justice?*
No
Yes
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.*
No
Yes
Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution?*
No
Yes
Have you ever been convicted in any court of a misdemeanor crime of domestic violence, or are you or have you ever been a member of the military and been convicted of a crime that included, as an element, the use of force against a person as identified in the instructions?*
No
Yes
What is your level of firearm experience?*
None
Beginner
Intermediate
Professional
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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