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Minor Release Addendum

By signing below, I represent I am the Parent or Legal Guardian of the Minor(s) listed below, and do hereby grant the following person (hereafter Designated Supervisor) permission to supervise and act as responsible party for activities using the shooting range at Shoot Indoors.

I further state I have completed the Shoot Indoors ‘Participant Agreement - Hold Harmless clause, Covenant Not to Sue, and Release’ waiver covering myself and said minor(s). I further state that I have legal custody of, and authority, to designate responsibility of said minor.

In addition, in the event of an emergency or non-emergency situation requiring medical or dental treatment, I hereby grant permission until such time I can be contacted. This permission includes, but is not limited to, the administration of First Aid, the use of an ambulance, and the administration of anesthesia and/or surgery, under the recommendation of qualified and licensed medical personnel.

I hereby acknowledge this Minor Release Addendum authorizes said minor to participate in all shooting activities at Shoot Indoors under the supervision of the Designated Supervisor.

First Parent's Name
First Name*
Middle Name
Last Name*
First Parent's Age Acknowledgment*
First Parent's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Parent's Signature*
Second Parent's Name
First Name*
Middle Name
Last Name*
Parent's Date of Birth*
Date of Birth
Third Parent's Name
First Name*
Middle Name
Last Name*
Parent's Date of Birth*
Date of Birth
Fourth Parent's Name
First Name*
Middle Name
Last Name*
Parent's Date of Birth*
Date of Birth
Fifth Parent's Name
First Name*
Middle Name
Last Name*
Parent's Date of Birth*
Date of Birth
Sixth Parent's Name
First Name*
Middle Name
Last Name*
Parent's Date of Birth*
Date of Birth
Seventh Parent's Name
First Name*
Middle Name
Last Name*
Parent's Date of Birth*
Date of Birth
Eighth Parent's Name
First Name*
Middle Name
Last Name*
Parent's Date of Birth*
Date of Birth
Ninth Parent's Name
First Name*
Middle Name
Last Name*
Parent's Date of Birth*
Date of Birth
Tenth Parent's Name
First Name*
Middle Name
Last Name*
Parent's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email
Check to receive information, news, and discounts by e-mail.
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Designated Supervisor
Name of Designated Supervisor *
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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
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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