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ERML SPORTSMEN’S FOUNDATION RANGE
Waiver of Liability, Release & Covenant Not to Sue

I hereby understand and agree to accept the risk of bodily injury and/or property damage which I may incur or cause a third party to incur as a result of my use of the range facilities and premises.  I understand that this risk includes, but is not limited to, any lead dust inhalation, noise, airborne materials or objects, including firearm projectiles, injuries incurred by natural hazards of the range facilities and the actions of other users of the range facilities.  I further agree to indemnify, defend, and hold harmless the ERML Sportsmen’s Foundation, Inc., Escambia River Muzzle Loaders, Inc. (doing business as Escambia River Gun Club), their officers, directors, agent, employees and members, from and against any and all claims, injuries, suits or judgments arising there from, or in connection with, my presence on the range facilities.  I agree to this indemnification and save harmless for myself, my successors, assigns, heirs, executors and administrators, and any other person or entity who may have a claim based upon my personal injuries or property damage.  I understand that engaging in or spectating any shooting activity constitutes my involvement in a potentially hazardous activities with accompanying risks of personal injury or death and loss or damage to personal property, and I hereby voluntarily assume those risks.

Furthermore, I have read and agree to abide by the rules and regulations pertaining to use of the range facilities.  I understand that I will be held financially responsible for any damage to the range facilities or occurs through my use of the same.

Today's Date: November 30, 2021

First Club Member Applicant Name

First Name*

Middle Name

Last Name*

Phone*
First Club Member Applicant Date of Birth*
I certify that I am 18 years of age or older
First Club Member Applicant Information

In order to limit the liability incurred by having guest(s) on the range who may be prohibited from using or being around firearms, please answer the following question by checking the answer "Yes" or "No":

Are you prohibited from carrying a firearm or being around firearms for any reason, including court order, mentally challenged, loss of membership/range rights from another gun club/range, controlled substance abuse, dishonorably discharged from armed forces, or designated a danger to other or domestic violence?*
First Club Member Applicant Signature*
Second Club Member Applicant Name

First Name*

Middle Name

Last Name*
Second Club Member Applicant Date of Birth*
Second Club Member Applicant Information

In order to limit the liability incurred by having guest(s) on the range who may be prohibited from using or being around firearms, please answer the following question by checking the answer "Yes" or "No":

Are you prohibited from carrying a firearm or being around firearms for any reason, including court order, mentally challenged, loss of membership/range rights from another gun club/range, controlled substance abuse, dishonorably discharged from armed forces, or designated a danger to other or domestic violence?*
Third Club Member Applicant Name

First Name*

Middle Name

Last Name*
Third Club Member Applicant Date of Birth*
Third Club Member Applicant Information

In order to limit the liability incurred by having guest(s) on the range who may be prohibited from using or being around firearms, please answer the following question by checking the answer "Yes" or "No":

Are you prohibited from carrying a firearm or being around firearms for any reason, including court order, mentally challenged, loss of membership/range rights from another gun club/range, controlled substance abuse, dishonorably discharged from armed forces, or designated a danger to other or domestic violence?*
Fourth Club Member Applicant Name

First Name*

Middle Name

Last Name*
Fourth Club Member Applicant Date of Birth*
Fourth Club Member Applicant Information

In order to limit the liability incurred by having guest(s) on the range who may be prohibited from using or being around firearms, please answer the following question by checking the answer "Yes" or "No":

Are you prohibited from carrying a firearm or being around firearms for any reason, including court order, mentally challenged, loss of membership/range rights from another gun club/range, controlled substance abuse, dishonorably discharged from armed forces, or designated a danger to other or domestic violence?*
Fifth Club Member Applicant Name

First Name*

Middle Name

Last Name*
Fifth Club Member Applicant Date of Birth*
Fifth Club Member Applicant Information

In order to limit the liability incurred by having guest(s) on the range who may be prohibited from using or being around firearms, please answer the following question by checking the answer "Yes" or "No":

Are you prohibited from carrying a firearm or being around firearms for any reason, including court order, mentally challenged, loss of membership/range rights from another gun club/range, controlled substance abuse, dishonorably discharged from armed forces, or designated a danger to other or domestic violence?*
Sixth Club Member Applicant Name

First Name*

Middle Name

Last Name*
Sixth Club Member Applicant Date of Birth*
Sixth Club Member Applicant Information

In order to limit the liability incurred by having guest(s) on the range who may be prohibited from using or being around firearms, please answer the following question by checking the answer "Yes" or "No":

Are you prohibited from carrying a firearm or being around firearms for any reason, including court order, mentally challenged, loss of membership/range rights from another gun club/range, controlled substance abuse, dishonorably discharged from armed forces, or designated a danger to other or domestic violence?*
Seventh Club Member Applicant Name

First Name*

Middle Name

Last Name*
Seventh Club Member Applicant Date of Birth*
Seventh Club Member Applicant Information

In order to limit the liability incurred by having guest(s) on the range who may be prohibited from using or being around firearms, please answer the following question by checking the answer "Yes" or "No":

Are you prohibited from carrying a firearm or being around firearms for any reason, including court order, mentally challenged, loss of membership/range rights from another gun club/range, controlled substance abuse, dishonorably discharged from armed forces, or designated a danger to other or domestic violence?*
Eighth Club Member Applicant Name

First Name*

Middle Name

Last Name*
Eighth Club Member Applicant Date of Birth*
Eighth Club Member Applicant Information

In order to limit the liability incurred by having guest(s) on the range who may be prohibited from using or being around firearms, please answer the following question by checking the answer "Yes" or "No":

Are you prohibited from carrying a firearm or being around firearms for any reason, including court order, mentally challenged, loss of membership/range rights from another gun club/range, controlled substance abuse, dishonorably discharged from armed forces, or designated a danger to other or domestic violence?*
Ninth Club Member Applicant Name

First Name*

Middle Name

Last Name*
Ninth Club Member Applicant Date of Birth*
Ninth Club Member Applicant Information

In order to limit the liability incurred by having guest(s) on the range who may be prohibited from using or being around firearms, please answer the following question by checking the answer "Yes" or "No":

Are you prohibited from carrying a firearm or being around firearms for any reason, including court order, mentally challenged, loss of membership/range rights from another gun club/range, controlled substance abuse, dishonorably discharged from armed forces, or designated a danger to other or domestic violence?*
Tenth Club Member Applicant Name

First Name*

Middle Name

Last Name*
Tenth Club Member Applicant Date of Birth*
Tenth Club Member Applicant Information

In order to limit the liability incurred by having guest(s) on the range who may be prohibited from using or being around firearms, please answer the following question by checking the answer "Yes" or "No":

Are you prohibited from carrying a firearm or being around firearms for any reason, including court order, mentally challenged, loss of membership/range rights from another gun club/range, controlled substance abuse, dishonorably discharged from armed forces, or designated a danger to other or domestic violence?*
Club Member Applicant 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*
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
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*
I certify that I am 18 years of age or older
Parent or Guardian's Information

In order to limit the liability incurred by having guest(s) on the range who may be prohibited from using or being around firearms, please answer the following question by checking the answer "Yes" or "No":

Are you prohibited from carrying a firearm or being around firearms for any reason, including court order, mentally challenged, loss of membership/range rights from another gun club/range, controlled substance abuse, dishonorably discharged from armed forces, or designated a danger to other or domestic violence?*
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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