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 I understand that Staccato 2011, LLC’s manufacturing facility contains equipment and work areas that can be dangerous, and participating in on-site tours, events, and shooting activities may result in my injury. 

I do hereby for myself, my successors, heirs, and assigns, fully and completely release indemnity and hold harmless Staccato 2011, LLC, its shareholders, directors, officers, affiliates, and employees from any and all claims, demands, and actions that I may have, or that my successors, heirs, or assigns may have, on account of loss, damage, or injury, including personal injury or death, that may be suffered by me, or my minor children, in connection with participating in stated events. 

I understand and acknowledge that my use of any Staccato handguns or other equipment shall be at my and their sole risk and exposure, and I hereby voluntarily assume any and all risks of loss, damage, or injury, including personal injury or death, known or unknown, potentially arising out of my use of this equipment or injury from participating in Staccato 2011, LLC events and tours. I also do hereby for myself, my successors, heirs, and assigns, fully and completely release, indemnify and hold harmless Staccato 2011, LLC, its shareholders, directors, officers, affiliates, and employees from any and all claims, demands, and actions that I may have, or that my successors, heirs, or assigns may have, on account of loss, damage, or injury, including personal injury or death, that may be suffered by me, or my minor children, in connection with the use of Staccato handguns, ammunition and or other equipment. 

I further agree to follow any and all safety rules communicated verbally, in writing, or through posted signs. I agree to participate in any on-site activities only in a manner that is safe. I also agree that I am physically able to participate in state activities. 

I have read and understand this agreement. 


October 24, 2024


First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Are you a Staccato 2011 owner?*
No
Yes
Are you a Member of Staccato 368, Staccato's exclusive owner's community?*
No
Yes

Emergency Contact Name

Emergency Contact Phone Number
Are you a Law Enforcement Officer?*
No
Yes

If yes, what Department are you with?
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Are you a Staccato 2011 owner?*
No
Yes
Are you a Member of Staccato 368, Staccato's exclusive owner's community?*
No
Yes

Emergency Contact Name

Emergency Contact Phone Number
Are you a Law Enforcement Officer?*
No
Yes

If yes, what Department are you with?
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Are you a Staccato 2011 owner?*
No
Yes
Are you a Member of Staccato 368, Staccato's exclusive owner's community?*
No
Yes

Emergency Contact Name

Emergency Contact Phone Number
Are you a Law Enforcement Officer?*
No
Yes

If yes, what Department are you with?
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Are you a Staccato 2011 owner?*
No
Yes
Are you a Member of Staccato 368, Staccato's exclusive owner's community?*
No
Yes

Emergency Contact Name

Emergency Contact Phone Number
Are you a Law Enforcement Officer?*
No
Yes

If yes, what Department are you with?
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Are you a Staccato 2011 owner?*
No
Yes
Are you a Member of Staccato 368, Staccato's exclusive owner's community?*
No
Yes

Emergency Contact Name

Emergency Contact Phone Number
Are you a Law Enforcement Officer?*
No
Yes

If yes, what Department are you with?
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Are you a Staccato 2011 owner?*
No
Yes
Are you a Member of Staccato 368, Staccato's exclusive owner's community?*
No
Yes

Emergency Contact Name

Emergency Contact Phone Number
Are you a Law Enforcement Officer?*
No
Yes

If yes, what Department are you with?
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Are you a Staccato 2011 owner?*
No
Yes
Are you a Member of Staccato 368, Staccato's exclusive owner's community?*
No
Yes

Emergency Contact Name

Emergency Contact Phone Number
Are you a Law Enforcement Officer?*
No
Yes

If yes, what Department are you with?
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Are you a Staccato 2011 owner?*
No
Yes
Are you a Member of Staccato 368, Staccato's exclusive owner's community?*
No
Yes

Emergency Contact Name

Emergency Contact Phone Number
Are you a Law Enforcement Officer?*
No
Yes

If yes, what Department are you with?
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Are you a Staccato 2011 owner?*
No
Yes
Are you a Member of Staccato 368, Staccato's exclusive owner's community?*
No
Yes

Emergency Contact Name

Emergency Contact Phone Number
Are you a Law Enforcement Officer?*
No
Yes

If yes, what Department are you with?
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Are you a Staccato 2011 owner?*
No
Yes
Are you a Member of Staccato 368, Staccato's exclusive owner's community?*
No
Yes

Emergency Contact Name

Emergency Contact Phone Number
Are you a Law Enforcement Officer?*
No
Yes

If yes, what Department are you with?
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.
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 Information
Are you a Staccato 2011 owner?*
No
Yes
Are you a Member of Staccato 368, Staccato's exclusive owner's community?*
No
Yes

Emergency Contact Name

Emergency Contact Phone Number
Are you a Law Enforcement Officer?*
No
Yes

If yes, what Department are you with?
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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