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Participation Agreement
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This PARTICIPATION AGREEMENT is made as of the date last signed below, between A Great Start Shooting School, LLC, a Connecticut limited liability company with its principal place of business located at 144 Mansfield Road, Harwinton CT 06791, referred to as the “School” and [[FULLNAME]] (you) residing at: [[ADDRESS]] referred to as the “Participant”.
In consideration of the mutual promises stated herein, for the purchase price and other fees paid by the Participant as set forth herein, and for other good and valuable consideration, the School and the Participant agree as follows:
1. FORM COMPLETION
Prior to taking any classes, or otherwise participating or observing any of the School’s firearms-related training or events, the Participant shall complete and sign a Hold Harmless Agreement / Liability Waiver and Release, and Emergency Medical Release Form, and a an acknowledgement that the Participant has read and shall strictly abide by, the School’s Safety Rules. Each such form shall be attached to, and become part of, this Agreement when countersigned by a duly authorized representative of the School.
2. PURCHASE PRICE AND FEES
A. PRICE: The Participant shall pay the School $0.00 for participation in the firearms training / event: Pistol Permit Class - Private Group.
B. Fifty percent (50%) of the participation fee shall be paid when enrolling in the course or event. This payment is nonrefundable. The balance of the participation fee shall be paid on or before the day of the class/event, prior to the start of the class/event.
C. For the price set forth above, the School will provide the Participant access to the School’s firearms training and/or event specified above at the School’s facility at 144 Mansfield Road, Harwinton CT 06791 or at such other location as the School may designate.
3. ALL RANGE RULES MUST BE OBSERVED
The Participant shall obey and comply with all of the School’s rules, as amended from time to time at the School’s discretion. The Participant shall be responsible for ensuring similar compliance with the School’s rules by any and all persons entering the School’s facilities as guests and/or visitors of the Participant. The Participant shall also be responsible for reporting to the School’s management any violation of the School’s rules which the Participant witnesses or becomes aware of.
4. PARTICIPANT’S ASSESSMENT OF FACILITIES
The Participant warrants that the Participant has, to a reasonable extent, inspected the School’s facilities, and has assessed the safety and fitness of said facilities for the purposes of the activities in which the Participant will engage. The Participant acknowledges and covenants that the School’s facilities are acceptable to the Participant, as is, with all observable defects, for said purposes. The Participant further acknowledges that the Participant shall have the continuing obligation to assess the safety and fitness of said facilities for said purposes, and to report to the School’s management any unfit or unsafe condition or conduct which the Participant witnesses or becomes aware of. Participant understands and agrees that Participant may be given permission to access lands not owned and/or controlled by the School. School shall have no duty to maintain or keep such lands safe for Participant’s use, nor shall the School have any duty to warn Participant of any known or unknown conditions on such lands. Participant uses all such lands and/or facilities at Participant’s own risk.
5. PARTICIPANT BEARS ALL RISK OF DEATH, BODILY INJURY AND PROPERTY DAMAGE
While Participant is at the School’s Facilities, and/or involved in any School-related activities, whether on lands owned and/or controlled by the School or by others, the School shall not be liable for any injury and/or death to the Participant which may be suffered by the Participant, or the Participant’s minor children, or for any other claim, action and/or cause of action arising from or during the presence of the Participant and/or the Participant’s minor children on said Facility and/or land, and/or the Participant’s participation in any such activities, even if said injury and/or death is caused by the School’s ordinary negligence. ALL RISKS TO THE PARTICIPANT AND THE PARTICIPANT’S MINOR CHILDREN ARE ASSUMED BY THE PARTICIPANT. THE PARTICIPANT AGREES TO INDEMNIFY THE SCHOOL AND HOLD THE SCHOOL HARMLESS FROM AND AGAINST ANY INJURY AND/OR DEATH TO THE PARTICIPANT AND/OR THE PARTICIPANT’S MINOR CHILDREN, EVEN IF SUCH INJURY OR DEATH IS CAUSED BY THE SCHOOL’S ORDINARY NEGLIGENCE.
All costs and losses of the Participant’s property connected with any School-related activities shall be borne solely by the Participant. The Participant agrees to hold the School harmless from and against any loss, damage and/or injury to the Participant’s property.The Participant further agrees to indemnify the School, and hold the School harmless, from any claim, action or cause of action asserted by any person or entity alleging damage or injury proximately caused by the Participant, the Participant’s minor children or the Participant’s property and agrees to pay all reasonable legal fees and costs incurred by the School in defense of any such claim, action or cause of action.
6. TERMINATION
Either party may terminate this Agreement at any time upon written notice to the other party. Notice of termination by the Participant does not relieve the Participant of any payment obligations otherwise due.
In the event the School terminates this Agreement for a material breach of this Agreement by the Participant, including, but not limited to a material breach of any of the School’s Safety Rules, as amended from time to time, no advanced notice on the part of the School shall be required, and no fees will be refunded to the Participant.
In the event the Participant is in material default of this Agreement, the School has the right to recover reasonable attorney’s fees and court costs from the Participant resulting from the failure of the Participant to satisfy a material term of this Agreement.
7. ASSIGNMENT
The Participant has no power to, and shall not, assign this Agreement and/or any rights or obligations under this Agreement, to any person or entity without prior written agreement by the School, and any such assignment absent the School’s prior written agreement shall be void.
8. INTEGRATION
This Agreement, including a) properly executed Hold Harmless Agreement, Liability Waiver and Release; b) a properly executed Emergency Medical Release Form; and, c) a properly executed copy of the School’s Safety Rules, constitutes the entire Agreement between the Parties. Unless otherwise stated herein for any given provision, in the event of a conflict between the terms stated in any document incorporated herein, the terms of the Hold Harmless Agreement, Liability Waiver and Release shall prevail. Thereafter, the following priority of documents shall control: the Emergency Medical Release Form, then the Range Rules. This Agreement, as integrated, supersedes any and all prior written or oral understandings and agreements of any kind between the Participant and the School with respect to its subject. This Agreement may be changed only by written amendment signed by both parties, except that the School’s Safety Rules may be amended from time to time at the School’s sole discretion.
9. INTERPRETATION AND JURISDICTION
The Participant and the School each warrant that they have had the opportunity to negotiate each of the terms of this Agreement, including the terms included in any and all attachments to this Agreement, and to consultwith their own counsel over the drafting of this Agreement, and that both parties shall be considered the drafterfor purposes of interpreting this Agreement.This Agreement shall be interpreted pursuant to the laws of the State of Connecticut without regard to any conflicts of law provisions. Exclusive jurisdiction for deciding any and all claims, demands or causes of action premised upon, stemming from, or related to this Agreement and/or any conduct addressed by this Agreement, and/or any damages or injuries alleged to have resulted from any such conduct, shall be in the courts of the State of Connecticut.
10. PARTIAL INVALIDITY
If any provision of this Agreement is held unenforceable or invalid by any court of competent jurisdiction, the remaining provisions of this Agreement shall remain in full force and effect to the fullest extent permitted by law.
11. BINDING EFFECT
The provisions of this Agreement shall be binding on the heirs, executors, administrators and assigns of the Parties in like manner as on the original Parties, unless modified in writing by mutual agreement of the Parties.
MY SIGNATURE BELOW INDICATES THAT I HAVE HAD THE OPPORTUNITY TO CONSULT MY OWN LEGAL COUNSEL AND TO NEGOTIATE THE TERMS OF THIS AGREEMENT, I HAVE READ THIS ENTIRE AGREEMENT INCLUDING ITS SUBPARTS AND ATTACHMENTS, I UNDERSTAND THE TERMS COMPLETELY, AND I AGREE TO BE LEGALLY BOUND BY THE TERMS OF THIS AGREEMENT IN THEIR ENTIRETY.
Date Acknowledged
*
MM slash DD slash YYYY
Legal Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
HOLD HARMLESS AGREEMENT LIABILITY WAIVER AND RELEASE
*
This HOLD HARMLESS AGREEMENT, LIABILITY WAIVER AND RELEASE (hereafter the “AGREEMENT”) is made and
entered into as of the date last signed below, by and between A G reat S tart S hooting S chool, L LC, a Connecticut
limited liability company (hereafter called the “COMPANY”), and Kat Testing (you) hereinafter called the
“PARTICIPANT,” and if Participant is a minor, Participant’s parent or guardian, {{Fullname:Recipient3}} (parent or
guardian) (together called “PARTICIPANT”). The Company and its parents, successors, assigns, subsidiaries,
affiliates, officers, owners, directors, instructors, range officers, employees and agents, and facilities on which
same operate are hereafter collectively and individually called the “School.”
In consideration of the School’s willingness to provide the Participant with access to the facilities and other good
and valuable consideration from the School to the Participant, receipt of which is hereby acknowledged, the
Participant hereby expressly agrees to the following:
1. The Participant acknowledges that being present at a facility where firearms are also present, and the acts
of using, handling, firing, cleaning, training with, working with, spectating, observing, or even simply being
in close proximity to, guns, firearms and/or ammunition (hereafter called “Firearm Activities”) are activities
accompanied by significant known and unknown risks and hazards. These risks and hazards, whether
ever-present or spontaneous, observable or unobservable, can result in serious bodily injury and/or death
to the Participant and those in proximity to the Firearm Activities. The Participant acknowledges that such
risks and hazards cannot be eliminated by any reasonable action of the School. The Participant
acknowledges that the Participant, and those within proximity of the Firearm Activities, can be seriously
injured and/or killed by such risks and hazards. {{Initial:Recipient2*}}
{{Initial:Recipient1*}}
2. The Participant agrees that the provisions of this Agreement, in which the Participant assumes all risks of,
and legal responsibility for, engaging in Firearm Activities, and in which the Participant waives and releases
the School from certain types of liability, including any liability premised on the School’s ordinary
negligence, are to be interpreted as broadly as possible, and are intended by the Participant and the
School to extend liability limitations to the School to the greatest extent and degree allowed by law. The
Participant understands that the discharge of a firearm results in a projectile being expelled at high speed,
and that anyone and anything that the projectile hits can be seriously injured, killed or severely damaged.
The Participant agrees that risks and hazards inherent in Firearms Activities, any or all of which may result
in serious bodily injury and/or death to persons, including the Participant, and damage to property include,
but are not limited to, the following: the accidental discharge of a firearm or the discharge of a firearm in
an unintended and/or unsafe direction resulting in a projectile striking a person or object; a projectile
travelling through, over or around an intended target or backstop and hitting an unintended person or
object; a projectile ricocheting off an object, including a target or backstop, and hitting an unintended
person or object; participants and bystanders behaving with or without warning in ways such as running,
stumbling, falling or stepping on a person or object, being distracted by such things as sounds, movement,
objects, persons and/or animals while handing firearms and ammunition, which may result in the
accidental discharge of a firearm or the discharge of a firearm in an unintended and/or unsafe direction;
unstable and/or unsuitable ground and environmental conditions; loud noise which may cause permanent
hearing damage; exposure to mercury, lead, petroleum and other chemical substances contained in some
ammunition and firearm cleaning products; equipment failure and malfunction, such as a firearm or
cartridge exploding or breaking and causing burning powers, burning gasses, metal fragments and/or
projectiles to strike persons or objects; recoil causing a firearm, a firearm’s moving parts and/or a spent
(and possibly hot) cartridge case to strike the person firing the firearm and/or another person with great
force; failure of mechanical safety mechanisms and devices; failure of protective gear resulting in damage
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to a person’s eyes, ears or other body parts; being matched with firearms and equipment not suited to
theParticipant’s size, strength, abilities and/or skill level; limited availability of emergency medical care
and/or equipment; the ordinary negligence of a participant, the School, and/or a third party including, but
not limited to the failure to adequately or properly instruct and/or supervise the Participant or other
persons, the failure to guard or warn against a dangerous condition, use, structure or activity, the failure to
maintain equipment, land, structures and/or facilities in safe and serviceable condition, that may cause or
contribute to injury or death to the Participant or another person, or damage to the property of the
Participant or another person.
3. The Participant agrees and understands that the School property and facility, and any non-School-owned
properties which the Participant might enter, are places where experienced and inexperienced participants
and bystanders are likely to be present and engaged in various firearm and non-firearm-related activities.
4. Each and all of the risks and hazards inherent in Firearm Activities, including without limitation each of
those stated in Paragraph b. and Paragraph c. above, any or all of which may result in grave bodily injury
and/or death to persons, including the Participant, and damage to property, are considered, are agreed to
be, and are hereafter called, “HAZARDS INHERENT IN FIREARM ACTIVITIES.”
5. EXCEPT AS SPECIFICALLY EXCLUDED HEREIN, THE PARTICIPANT AGREES TO ASSUME ANY AND ALL RISKS,
INCLUDING WITHOUT LIMITATION THE RISKS OF DEATH, BODILY INJURY, AND/OR PROPERTY DAMAGE
RESULTING FROM THE HAZARDS INHERENT IN FIREARM ACTIVITIES INCLUDING THOSE HAZARDS
PROXIMATELY CAUSED BY THE SCHOOL’S ORDINARY NEGLIGENCE.
6. THE PARTICIPANT WAIVES, RELEASES, AND AGREES TO INDEMNIFY AND DEFEND THE SCHOOL AGAINST,
AND HOLD THE SCHOOL HARMLESS FROM, ANY AND ALL CLAIMS, CAUSES OF ACTION, DAMAGES,
JUDGMENTS, COSTS OR EXPENSES, INCLUDING COURT COSTS AND REASONABLE ATTORNEY’S FEES, WHICH
IN ANY WAY DIRECTLY OR INDIRECTLY ARISE FROM THE PARTICIPANT’S USE OF FIREARMS, PRESENCE AT
THE SCHOOL’S FACILITIES OR INVOLVEMENT IN THE SCHOOL’S TRAINING AND EVENTS AND/OR THE
HAZARDS INHERENT IN FIREARM ACTIVITIES INCLUDING THOSE HAZARDS PROXIMATELY CAUSED BY THE
SCHOOL’S ORDINARY NEGLIGENCE.
7. PARTICIPANT FURTHER AGREES NOT TO SUE THE SCHOOL ON ACCOUNT OF OR IN CONNECTION WITH ANY
CLAIMS, CAUSES OF ACTION, INJURIES, DAMAGES, COSTS OR EXPENSES, INCLUDING WITHOUT
LIMITATION, THOSE BASED ON DEATH, BODILY INJURY, PROPERTY DAMAGE, ECONOMIC, NON-ECONOMIC
AND/OR CONSEQUENTIAL DAMAGES WHICH IN ANY WAY DIRECTLY OR INDIRECTLY ARISE FROM THE
PARTICIPANT’S USE OF FIREARMS, PRESENCE AT THE SCHOOL’S FACILITIES OR INVOLVEMENT IN THE
SCHOOL’S TRAINING AND EVENTS AND/OR THE HAZARDS INHERENT IN FIREARM ACTIVITIES INCLUDING
THOSE HAZARDS PROXIMATELY CAUSED BY THE SCHOOL’S ORDINARY NEGLIGENCE.
8. It shall be the Participant’s express and exclusive duty and obligation to, and the Participant agrees that
he/she must and shall:
A. learn, follow, and abide by, all of the School’s rules and regulations as may be amended by the School
from time to time; {{Initial:Recipient2*}}
{{Initial:Recipient1*}}
B. continually assess to the Participant’s satisfaction the safety and soundness of all equipment, facilities,
policies and procedures at the School’s facilities and events, and to immediately notify the School’s
management in the event any unsafe or unsound condition is observed;
C. personally ensure that all equipment used by the Participant (including any provided by the School),
shall be in proper physical condition, properly fitted, properly adjusted, and properly matched to the
Participant’s abilities and skill level, so as to be suitably and safely used by the Participant.
9. The Participant agrees to waive the protection afforded by any statute or law the purpose, substance
and/or effect of which is to provide that a general release shall not extend to claims, material or otherwise,
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which the person giving the release does not know or suspect to exist at the time of executing the release.
10. The Participant and the School each warrant that they have had the opportunity to negotiate each of the
terms of this Agreement, and to consult with their own counsel over the wording of this Agreement, and
that both parties shall be considered the drafter for purposes of interpreting this Agreement.
11. This Agreement shall be interpreted pursuant to the laws of the State of Connecticut without regard to any
conflicts of law provisions. If any term or provision of this Agreement is held unenforceable or invalid by a
court of competent jurisdiction, the remaining provisions shall remain in full force and effect to the fullest
extent permitted by law. Exclusive jurisdiction for deciding any and all claims, demands or causes of action
premised upon, stemming from, or related to this Agreement and/or any conduct addressed by this
Agreement, and/or any damages or injuries alleged to have resulted from any such conduct, shall be in the
courts of the State of Connecticut.
12. The provisions of this Agreement shall be binding on the heirs, executors, administrators and assigns of the
Parties in like manner as on the original Parties, unless modified in writing by mutual agreement of the
Parties.
13. The Participant shall have no power to assign or transfer this Agreement nor any right or obligation
hereunder, and any attempt to so assign or transfer shall be void and of no legal effect.
14. The foregoing constitutes the entire agreement between the parties and may be modified only by a writing
signed by both parties. This Agreement may be incorporated into other agreements, but no other
agreement may be incorporated into, nor change the terms, conditions or warranties of this Agreement.
MY SIGNATURE BELOW INDICATES THAT I HAVE HAD THE OPPORTUNITY TO CONSULT MY OWN LEGAL
COUNSEL AND TO NEGOTIATE THE TERMS OF THIS AGREEMENT, I HAVE READ THIS ENTIRE AGREEMENT, I
UNDERSTAND THE TERMS COMPLETELY AS WRITTEN, I UNDERSTAND I AM GIVING UP CERTAIN LEGAL RIGHTS,
AND I AGREE TO BE LEGALLY BOUND BY THE TERMS OF THIS AGREEMENT IN THEIR ENTIRETY.
I agree to all of the above.
Date Acknowledged
*
MM slash DD slash YYYY
Legal Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
EMERGENCY MEDICAL RELEASE FORM
ADULT
Name
First
Last
Date of Birth
MM slash DD slash YYYY
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
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Israel
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Jamaica
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Jersey
Jordan
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Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
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Latvia
Lebanon
Lesotho
Liberia
Libya
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Macao
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Mali
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Martinique
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Mayotte
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Montenegro
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Norway
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Panama
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Saint Helena, Ascension and Tristan da Cunha
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Samoa
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Virgin Islands, U.S.
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Country
Phone
Emergency Contact Name
First
Last
Emergency Contact Phone Number
*
Do you have an active health insurance policy?
*
Yes
No
Do you have allergies?
*
Yes
No
Do you wear contact lenses?
*
Yes
No
What are you allergic to?
RELEASE BY ADULT PARTICIPANT FOR MEDICAL TREATMENT
*
If emergency medical care is required for myself and if neither I, nor an accompanying spouse or adult relative, is
able to convey authority to administer such treatment in a timely manner, I hereby waive my right of informed
consent and unconditionally grant A Great Start Shooting School, LLC and its officers, owners, directors,
employees and agents (together, the “School”) complete and unquestioned authority to summon and authorize
the administration of emergency medical care as deemed appropriate by emergency medical personnel, a
physician, and/or any medical facility providing treatment, and I further authorize such medical personnel and/or
facility to administer such treatment to me. I agree and warrant that I shall be solely responsible to pay all costs
relating to all such care and/or treatment, and shall indemnify, hold harmless and defend the School for any
actions they may take or fail to take in obtaining or administering, or attempting to obtain or administer,
emergency medical treatment for me.
I agree to all of the above.
Name
First
Last
Date
MM slash DD slash YYYY
SCHOOL SAFETY RULES
*
Everyone who is present at the events and/or facilities of A Great Start Shooting School, LLC (“School”) is subject to, and required to abide by, the School’s Safety Rules as may be amended from time to time at the School’s sole discretion. Before any person may participate in any School training or event, he or she must sign a copy of the School’s Safety Rules attesting that he/she has read and understands such rules, and affirming that he/she agrees to fully abide by each and every such rule. Failure to abide by the School’s Safety Rules shall be grounds for immediate expulsion from the School’s training and events, and grounds for immediate removal from the premises upon which such activities are being held.
I. GENERAL SCHOOL RULES
All Participants, Students and Guests must execute and deliver a Liability Waiver and Release, in a form to be determined by the parties, to the School’s management before participating in any Firearm Activities. The School is not responsible for lost or stolen articles.
II. THE 12 GOLDEN RULES FOR SAFE GUN HANDLING
1. Always treat the gun as if it was loaded.
2. Always keep the gun pointed in a safe direction.
3. Always keep your finger straight and off the trigger until you are ready to shoot.
4. Always keep the gun unloaded until you are ready to use it.
5. Never point the gun at anything you don't intend to destroy.
6. Be sure of your target and what is beyond it.
7. Know the mechanical and handling characteristics of the gun you are using.
8. Always use proper Ammunition.
9. Be sure the barrel is clear of obstructions before loading and shooting.
10. If your gun fails to fire when the trigger is pulled, hold your shooting position for several seconds; then with the muzzle pointed in a safe direction, carefully unload the gun.
11. Don't rely on the gun's safety mechanisms to keep it from firing.
12. Be aware of your surroundings when handling guns so you don't trip or lose your balance and accidentally point and/or fire the gun at anyone or anything.
III. RANGE SAFETY RULES
1. Always keep the barrel pointed down range.
2. Listen and follow Range Master commands
3. Always keep the gun on safe until you intend to shoot.
4. Always wear eye and ear protection when shooting.
5. Never shoot at water or hard surfaces.
6. EVERYONE near the range must wear appropriate hearing and eye protection – NO EXCEPTIONS!
7. Appropriate dress is a must for all shooters. No open toed shoes or low-cut shirts.
8. All shooters may load and unload their firearms only under the direct supervision of a Range Safety Officer or Instructor.
9. Always place targets so that you are shooting directly into the berm.
10. If anyone sees an unsafe situation they should call a cease fire. When a cease fire is called everyone must stop what they are doing until the issue is resolved.
IV. SAFETY AREA RULES
1. No ammunition allowed in the Safe Area.
2. Use this area to practice mounting, drawing, "dry-firing" and holstering and re-holstering of unloaded firearms.
3. Practice the insertion and removal of empty magazines and/or cycle the action of a firearm.
4. Use the safety table to case/uncase your firearm, conduct inspections, firearm stripping (takedown), cleaning, repair and/or maintenance and inspect your range gear/accessories.
5. No ammunition is allowed in the safety area. This includes dummy, practice, snap caps or empty cases, loaded magazines, speed loaders or other ammunition feeding devices.
6. Ammunition in the Safe Area will get you sent home.
I HAVE READ AND FULLY UNDERSTAND THE AFORESAID RULES, AGREE TO ABIDE BY THEM AS AMENDED FROM TIME TO TIME, AND WILL BE RESPONSIBLE FOR MY FAMILY’S AND GUESTS’ AWARENESS AND COMPLIANCE WITH THESE RULES.
Name
*
First
Last
Date
*
MM slash DD slash YYYY
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