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Release, Indemnification and Hold Harmless Agreement 

Shield the Flock, LLC 

In consideration of participating in Active Assailant Response Training, Tactical Emergency Casualty Care training, other training within Shield the Flock’s Core Training program and for other good and valuable consideration, I hereby agree to release and discharge from liability arising from negligence Shield the Flock, LLC and its owners, directors, instructors, officers, employees, agents, volunteers, participants, and all other persons or entities acting for them (hereinafter collectively referred to as “Releasees”) on behalf of myself and my children, parents, heirs, assigns, personal representative and estate, and also agree as follows:

1. I acknowledge that active assailant response training, tactical emergency casualty care training and other practical training offered by Shield the Flock, LLC involves known and unanticipated risks which could result in physical or emotional injury, paralysis or permanent injury, death, and property damage. Risks include, but are not limited to, death, paralysis, broken bones, torn ligaments, bruises, and other bodily injuries caused by contact with other participants, objects used during practical training related activities, training aids, or walls, matting, or the floor, medical conditions resulting from physical activity, and damaged clothing or property. I understand such risks cannot be eliminated, despite the use of safety equipment, without jeopardizing the essential quality of the activity.


2. I understand that the active assailant response tactics, tactical emergency casualty care training, PowerPoint presentation and tabletop exercises taught by Shield the Flock, LLC and its Releasees provide me, or my family member, with the safest and most up to date way to overcome and/or escape an assault. However, I understand that the Releasees cannot guarantee my safety through the use, or misuse, of the techniques taught in the class. I understand that I am responsible for the use of knowledge and techniques and any possible injury or damage which could result.


3. I expressly accept and assume all the risks inherent in this activity, or that might have been caused by the negligence of the Releasees. My participation in this activity is purely voluntary, and I elect to participate despite the risks. In addition, if at any time I believe the event conditions are unsafe or that I am unable to participate due to physical or medical conditions, then I will immediately discontinue participation.


4. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Releasees from any and all claims, demands or causes of action, which are in any way connected with my participation with this activity, or my use of their equipment, or facilities arising from negligence. This release does not apply to claims arising out of intentional conduct. Should Releasees or anyone acting on their behalf be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.


5. I represent that I have adequate insurance to cover my injury or damage that I may suffer or cause while participating in this activity, or else I agree to bear the costs of such injury or damage myself. I further represent that I have no medical or physical conditions which could interfere with my safety in this activity, or else I am willing to assume and bear the costs of-all risks that may be caused directly or indirectly, by any such condition.


6. In the event that I file a lawsuit, I agree to do so solely in the state where Shield the Flock LLC, is located, and I further agree that the substantive law of that state shall apply.


7. I agree that if any portion of this agreement is found to be void or unenforceable the remaining portions shall remain in full force and effect.


By signing this document, I agree that if I am hurt or my property is damaged during my participation in this activity, then I may be found by a court of law to have waived my right to maintain a lawsuit against the parties being released on the basis of any claim for negligence. I have read and understood this document, and I agree to be bound by its terms and conditions.

First Student/Participant Name
First Name*
Middle Name
Last Name*
Phone*
First Student/Participant Date of Birth*
Date of Birth
First Student/Participant Signature*
Second Student/Participant Name
First Name*
Middle Name
Last Name*
Phone*
Student/Participant Date of Birth*
Date of Birth
Third Student/Participant Name
First Name*
Middle Name
Last Name*
Phone*
Student/Participant Date of Birth*
Date of Birth
Fourth Student/Participant Name
First Name*
Middle Name
Last Name*
Phone*
Student/Participant Date of Birth*
Date of Birth
Fifth Student/Participant Name
First Name*
Middle Name
Last Name*
Phone*
Student/Participant Date of Birth*
Date of Birth
Sixth Student/Participant Name
First Name*
Middle Name
Last Name*
Phone*
Student/Participant Date of Birth*
Date of Birth
Seventh Student/Participant Name
First Name*
Middle Name
Last Name*
Phone*
Student/Participant Date of Birth*
Date of Birth
Eighth Student/Participant Name
First Name*
Middle Name
Last Name*
Phone*
Student/Participant Date of Birth*
Date of Birth
Ninth Student/Participant Name
First Name*
Middle Name
Last Name*
Phone*
Student/Participant Date of Birth*
Date of Birth
Tenth Student/Participant Name
First Name*
Middle Name
Last Name*
Phone*
Student/Participant Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Parent or Guardian's Driver's License / ID Card
Driver's License / ID Card Number*
Issuing State*
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*
Date of Birth
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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