Obsidian Sportsman and Defense Membership Application and Agreements

OBSIDIAN SPORTSMAN AND DEFENSE CLUB

MEMBERSHIP APPLICATION AND AGREEMENTS
Primary Member's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Email Address
example@example.com
Date of Birth

MonthDayYear
Date
Driver's License Number
Driver's License State
License Expiration Date

MonthDayYear
Date
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.
Are you already a member of the National African American Gun Association (NAAGA)?

YesNo
What is your NAAGA Membership Number?
When does your NAAGA Membership Expire?

MonthDayYear
Date
How did you hear about Obsidian?
Additional Member's Name (Spouse or Significant Other that resides at the same address)

First NameLast Name
Cell Phone Number
Please enter a valid phone number.
Email Address
example@example.com
Driver's License Number
Driver's License State
License Expiration Date

MonthDayYear
Date
Date of Birth

MonthDayYear
Date
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.
(Additional members over the age of 18 must fill out separate waivers)

Membership within Obsidian Sportsman and Defense Club will be available to persons who are legally able to possess a firearm. Obsidian Members must follow all federal, state and local laws concerning ownership and handling of firearms. Membership will be granted, and may be revoked, at the sole discretion of Obsidian Sportsman and Defense Club.

I certify as follows:
1. I am not and have never been the subject of a criminal or any other proceeding that prevents me from legally owning, handling or possessing firearms under State or Federal law.
2. I can lawfully own, handle and possess a firearm.
3. All information given in this application is true and correct to the best of my knowledge.
I have read, I understand, and I agree to comply with the Terms and Conditions, the Release, Assumption of Risk and Indemnity Agreement and the Obsidian Code of Conduct attached to this application.
Primary Member's Name

First NameLast Name
Primary Member's Signature

Clear
Date Signed

MonthDayYear
Date
Additional Member's Name (Spouse or Significant Other)

First NameLast Name
Additional Member's Signature

Clear
Date Signed

MonthDayYear
Date
Additional Family Member's Name (#3)

First NameLast Name
Date of Birth

MonthDayYear
Date
Age
Relationship to Primary Member
Additional Family Member's Name (#4)

First NameLast Name
Date of Birth

MonthDayYear
Date
Age
Relationship to Primary Member
Additional Family Member's Name (#5)

First NameLast Name
Date of Birth

MonthDayYear
Date
Age
Relationship to Primary Member
Do you have any firearms experience?

YesNo
Please explain....

MEMBERSHIP TERMS AND CONDITIONS

a. Membership in the Obsidian Sportsman and Defense Club is a privilege that can be revoked for unsafe or inappropriate conduct. ALL club members, family guests and nonfamily guests – WITHOUT EXCEPTION – must acknowledge, meet and adhere to all the following Rules, Regulations and Conditions. As a condition of Membership, any violation of Club rules and regulations or unsportsmanlike conduct by the Club Member or Guest will result in expulsion of the offender and disciplinary action against the Club Member up to and including termination of membership privileges.
Member's Initials
b. All Club Members and Guests are required to be of good character and reputation. No Club Member or Guest can have any felony or misdemeanor domestic violence criminal record; be prohibited from handgun ownership by State or Federal Law; nor can be a member of any organization which has as any part of its program, the attempt to overthrow the Government of the United States or any of its States by force or violence.
Member's Initials
c. The total number of Guests (family and non-family alike) allowed to non-exclusive Member activities cannot exceed 2 Guests per individual Club Member.
Member's Initials
d. All Members and Guests must obey the Obsidian’s Code of Conduct and must review, agree to the terms of, and sign the Adult Release, Assumption of Risk and Indemnity Agreement prior to Club activities. Club Members will turn all waivers into the Club.
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e. Club Members will ensure that every Guest reviews Obsidian’s Minimum Safety Practices.
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f. All Guests must be accompanied by a Member to be admitted to Club activities. Members are responsible for all actions taken by their Guests and will hold Obsidian harmless for property damage, accidents and injuries to or caused by Guests.
Member's Initials
g. All Guests will acknowledge that he or she is an invited guest of a Member of a private club; that access and participation in Club activities is conditional and subject to all Club rules; their presence at Club activities and/or ranges may be suspended or terminated at any time by the Club Member and/or a Club Officer for violation of the Code of Conduct or for behavior deemed unsafe by Obsidian personnel; and if told or requested to leave a Club function, the Guest agrees to do so immediately. Decisions of Obsidian regarding suspension or expulsion are final.
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h. All Members and Guests are subject to the general policies and rules of operation and administration by Obsidian, all of which are intended to provide a safe, friendly and family-oriented club.
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i. A Membership may be unilaterally terminated by Obsidian if, in the sole discretion of Obsidian leadership, the conduct of a Member or the Member's Guest presents a safety hazard to the Member or to any other member of Obsidian or to Obsidian facilities. In no event will there be any refund of any Membership Fees or Initiation Fees.
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j. The Membership shall be considered "abandoned" and terminated in the event of nonpayment of the Annual Membership Fee(s) after two consecutive months of the beginning of a new membership period. There is no refund of any portion of Membership Fees paid in the event the Membership is abandoned.
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k. Any destruction of Obsidian property caused by a Member or a Member's Guest, whether accidental, negligent, and willful or otherwise, may result in the violator being removed from the range and/or activity, suspended or removed from Membership, and/or criminally prosecuted. In addition, Obsidian reserves the right to assess to the Member a reasonable charge for any such damage, regardless of whether the damage is caused by the Member or the Member's Guest.
Member's Initials
l. Members may name an Additional Members to utilize the benefits of Membership. The Additional Member must be of the Member’s immediate family (i.e. wife, husband, father, mother, son, daughter or significant other that possess state identification that verifies that they share the same address) and are eligible for Junior or Associate membership.
Member's Initials
m. The Member is responsible for all Membership Fees including any fees pertaining to the Additional Member. The Member will be billed on a yearly basis for the Additional Member(s). The Additional Membership(s) may be cancelled by the Member with 30 days written noticed provided to Obsidian.
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n. Every Club Member must always carry his/her membership card and photo identification when engaged in Club functions. Any Club Member is authorized to ask any individual to show his/her membership card and photo identification. If the person does not have a membership card and photo identification, the Club Member can ask the person to leave the function and the person without valid proof of membership must comply. Failure to comply with such request may result in law enforcement being summoned to escort the person from the premises, and if the person is a member in good standing, may result in disciplinary action against them.
Member's Initials
o. A person who is lawfully authorized to carry loaded firearms and who is present for non-shooting activities (meetings, etc.) is permitted to carry a loaded firearm on their person provided the handgun remains holstered at all times and the facility in use does not prohibit possession.
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p. On ranges, all firearms must be unloaded AND either holstered unloaded or clearly visible with the actions open unless the shooter is on the firing line facing downrange preparing to shoot.
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q. Club Members are responsible for picking up their own trash, empty shell casings and target materials. Members will clean up their shooting areas/bays and dispose of trash in approved refuse containers. Disposal of live ammunition or misfired rounds in refuse containers is PROHIBITED.
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r. Club Members and Guests are always required to wear both hearing and eye protection when on shooting ranges.
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s. Club Members and Guests are responsible for the loss or damage of personal articles.
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t. In the event of an emergency during a Club activity:
1. Call 9-1-1. Speak firmly and calmly. Give the dispatcher the address where the Club activity is taking place.
2. Render aid.
3. Facilitated the arrival of First Responders; if possible, meet them at the nearest entrance and lead them to the victim.
4. Unload and secure all firearms.
5. Notify a Club Member or Executive Committee Member as soon as possible.
Member's Initials
u. Obsidian members and guest will always obey these minimum safety practices:
1. Treat all firearms as if they are loaded.
2. Never point a firearm at anything you do not intend to destroy, including yourself.
3. Keep your finger high and off the trigger until your sights are aligned with your target and the decision to shoot is made.
4. Always know your target, what is in front of it and what is behind it.
5. Keep the action open and gun unloaded until ready to use.
6. Know how your gun operates.
7. Be sure your gun and ammunition are compatible.
8. Wear eye and ear protection as appropriate.
9. Alcohol or drugs are prohibited before and during shooting activities.
10. Be aware that circumstances may require additional rules unique to a particular situation. You are responsible for gun safety.
Member's Initials
Primary Member's Name

First NameLast Name
Primary Member's Signature

Clear
Date Signed

MonthDayYear
Date
Additional Member's Name (Spouse or Significant Other)

First NameLast Name
Additional Member's Signature

Clear
Date Signed

MonthDayYear
Date

OBSIDIAN SPORTSMAN AND DEFENSE

RELEASE, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

for PRIMARY MEMBER

READ AND INITIAL AFTER EVERY PARAGRAPH
I, blanks (hereinafter “Member”) being of sound mind and entering into this agreement of my own free will, do hereby acknowledge that I voluntarily agree to join as a member of the Obsidian Sportsman and Defense Club (hereinafter “Club.”), and to abide by any and all rules set forth to participate as part of said Club.
Member's Initials
Member acknowledges that Member will participate in any and all activities of Club, which include, but is not limited to, entering onto premises where Members and other Individuals will be in possession of a firearm (s), active shooting, firearm (s) training, and/or the observation of active shooting. Member agrees that Member has voluntarily entered onto public and/or private property and/or ranges, and Member acknowledges that he/she has done so fully appreciating that he/she are participating in such activities, which are considered inherently dangerous. Furthermore, Member acknowledges that by participating in such inherently dangerous activities, he/she risk serious bodily injury, up to and including death.
Member's Initials
Furthermore, I acknowledge and understand that shooting activities are inherently hazardous and involve both known and unknown risks, which could result in death, serious bodily injury, emotional distress, mental anguish, and/or property damage directly and/or indirectly to myself of others. These risks include, but, are not limited to being shot by or shooting myself or others; partial or total loss of eyesight or hearing; inhalation or other harmful contact with lead or other contaminants; and being struck by flying or falling objects. I further understand the discharge of firearms and the use of ammunition are inherently dangerous activities, which no amount of care, instruction, or expertise can eliminate.
Member's Initials
Member acknowledges and agrees it is my responsibility to become experienced and skilled in the proper handling, loading, use and discharge of all firearms and ammunition Member intends to use during Club activities. I understand that Club is specifically relying on the truth of my representations concerning my experience with firearms, in permitting me to participate in Club activities. Any and all training by any other Club Member is being provided for demonstrative purposes, and there are no warranties and/or assurances regarding your personal safety express and/or implied.
Member's Initials
I represent that I have never been convicted of a felony in any of the 50 United States. Kentucky law prohibits any person convicted of a felony to be present in any environment where firearms are present.
Member's Initials
As lawful consideration for being permitted membership to Obsidian and to engage in or observe shooting and club activities, as a Participant, I agree as follows:
I agree to assume full responsibility for any and all risks, injuries, or damages, known or unknown, of whatsoever any kind and nature, which I might incur as a result of the participation in Club activities, the use of Club facilities or equipment and in engaging in or observing shooting and other Club activities.
Member's Initials
I agree to abide by Obsidian's Code of Conduct.
Member's Initials
I knowingly, voluntarily and expressly waive any and all legal claims or potential legal claims that I may have against the Obsidian Sportsman and Defense Club, its agents, officers, members, employees, instructors, volunteers, and/or representatives from any and all injuries or damages, up to and including death, that I may sustain as a result of me participating in Club activities, using Club facilities or equipment, or engaging in or observing shooting activities.
Member's Initials
In the event of death, serious bodily injury, and/or property damage, I am providing written notice to my next of kin, heirs, guardians, representatives, and/or assigns that I intended to release, waive, discharge and/or covenant not to sue the Obsidian Sportsman and Defense Club, its agents, officers, members, employees, instructors, volunteers, or representatives for any personal injury, death, disability, property damage, property theft or acts and/or omissions of whatsoever kind and nature including, but not limited to, those caused by its negligence or other acts including, but not limited to, those acts and/or omissions of other Participants or Members of the Club.
Member's Initials
I further acknowledge and agree that it is my understanding and intent that this Agreement, and any signed written amendments or modifications to it, shall remain in full force and effect from the date of execution and ever after shall be applicable to each and every occasion that I participate in Club activities, use Club facilities or equipment or engage in or observe shooting and other activities conducted or sponsored by the Club.
Member's Initials
I acknowledge and agree that if an individual pursues legal action in any civil court, as a result of my actions and/or inactions, directly related to my membership, participation, and/or affiliation with Club or its activities, that I will indemnify and hold harmless, the Club and/or its Members for any and all costs, which includes court costs and attorney’s fees required to defend such an action.
Member's Initials
I have carefully read this "Release, Assumption of Risk and Indemnity Agreement" and fully know its contents. I acknowledge that no other inducement, assurance or guarantee has been made to me in consideration of my signing this Agreement which I sign voluntarily and of my own free will. I further acknowledge and agree that this Agreement may be amended or modified only by a writing signed by me and by an authorized agent of the Obsidian Sportsman and Defense Club.
Primary Member's Name

First NameLast Name
Primary Member's Signature

Clear
Date Signed

MonthDayYear
Date

OBSIDIAN SPORTSMAN AND DEFENSE

RELEASE, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

for SPOUSE or SIGNIFICANT OTHER

READ AND INITIAL AFTER EVERY PARAGRAPH
I, blanks (hereinafter “Member”) being of sound mind and entering into this agreement of my own free will, do hereby acknowledge that I voluntarily agree to join as a member of the Obsidian Sportsman and Defense Club (hereinafter “Club.”), and to abide by any and all rules set forth to participate as part of said Club.
Member's Initials
Member acknowledges that Member will participate in any and all activities of Club, which include, but is not limited to, entering onto premises where Members and other Individuals will be in possession of a firearm (s), active shooting, firearm (s) training, and/or the observation of active shooting. Member agrees that Member has voluntarily entered onto public and/or private property and/or ranges, and Member acknowledges that he/she has done so fully appreciating that he/she are participating in such activities, which are considered inherently dangerous. Furthermore, Member acknowledges that by participating in such inherently dangerous activities, he/she risk serious bodily injury, up to and including death.
Member's Initials
Furthermore, I acknowledge and understand that shooting activities are inherently hazardous and involve both known and unknown risks, which could result in death, serious bodily injury, emotional distress, mental anguish, and/or property damage directly and/or indirectly to myself of others. These risks include, but, are not limited to being shot by or shooting myself or others; partial or total loss of eyesight or hearing; inhalation or other harmful contact with lead or other contaminants; and being struck by flying or falling objects. I further understand the discharge of firearms and the use of ammunition are inherently dangerous activities, which no amount of care, instruction, or expertise can eliminate.
Member's Initials
Member acknowledges and agrees it is my responsibility to become experienced and skilled in the proper handling, loading, use and discharge of all firearms and ammunition Member intends to use during Club activities. I understand that Club is specifically relying on the truth of my representations concerning my experience with firearms, in permitting me to participate in Club activities. Any and all training by any other Club Member is being provided for demonstrative purposes, and there are no warranties and/or assurances regarding your personal safety express and/or implied.
Member's Initials
I represent that I have never been convicted of a felony in any of the 50 United States. Kentucky law prohibits any person convicted of a felony to be present in any environment where firearms are present.
Member's Initials
As lawful consideration for being permitted membership to Obsidian and to engage in or observe shooting and club activities, as a Participant, I agree as follows:
I agree to assume full responsibility for any and all risks, injuries, or damages, known or unknown, of whatsoever any kind and nature, which I might incur as a result of the participation in Club activities, the use of Club facilities or equipment and in engaging in or observing shooting and other Club activities.
Member's Initials
I agree to abide by Obsidian's Code of Conduct.
Member's Initials
I knowingly, voluntarily and expressly waive any and all legal claims or potential legal claims that I may have against the Obsidian Sportsman and Defense Club, its agents, officers, members, employees, instructors, volunteers, and/or representatives from any and all injuries or damages, up to and including death, that I may sustain as a result of me participating in Club activities, using Club facilities or equipment, or engaging in or observing shooting activities.
Member's Initials
In the event of death, serious bodily injury, and/or property damage, I am providing written notice to my next of kin, heirs, guardians, representatives, and/or assigns that I intended to release, waive, discharge and/or covenant not to sue the Obsidian Sportsman and Defense Club, its agents, officers, members, employees, instructors, volunteers, or representatives for any personal injury, death, disability, property damage, property theft or acts and/or omissions of whatsoever kind and nature including, but not limited to, those caused by its negligence or other acts including, but not limited to, those acts and/or omissions of other Participants or Members of the Club.
Member's Initials
I further acknowledge and agree that it is my understanding and intent that this Agreement, and any signed written amendments or modifications to it, shall remain in full force and effect from the date of execution and ever after shall be applicable to each and every occasion that I participate in Club activities, use Club facilities or equipment or engage in or observe shooting and other activities conducted or sponsored by the Club.
Member's Initials
I acknowledge and agree that if an individual pursues legal action in any civil court, as a result of my actions and/or inactions, directly related to my membership, participation, and/or affiliation with Club or its activities, that I will indemnify and hold harmless, the Club and/or its Members for any and all costs, which includes court costs and attorney’s fees required to defend such an action.
Member's Initials
I have carefully read this "Release, Assumption of Risk and Indemnity Agreement" and fully know its contents. I acknowledge that no other inducement, assurance or guarantee has been made to me in consideration of my signing this Agreement which I sign voluntarily and of my own free will. I further acknowledge and agree that this Agreement may be amended or modified only by a writing signed by me and by an authorized agent of the Obsidian Sportsman and Defense Club.
Additional Member's Name (Spouse or Significant Other)

First NameLast Name
Additional Member's Signature

Clear
Date Signed

MonthDayYear
Date

CODE OF CONDUCT
1. No members with a record of a “Violent Felony” will be allowed to become members of NAAGA.
2. This is a private organization, and all potential members must apply and can be declined at the discretion of the Chapter President. No racist, sexist, anti – religious, or homophobic statements will be tolerated by any NAAGA members. Additionally, no verbal discussions or statements advocating any acts of violence toward Police, Military, and/or Government officials will be allowed.
3. Minors under the age of 18 must be accompanied by a parent or legal guardian who will always sign a waiver and remain by their side at the range.
4. Children must be at least 10 years old and be able to shoot over bench in a safe manner. Safe participation is the sole judgment of Obsidian personnel.
5. No violence toward any members or the public will be tolerated under any circumstance.
6. No sexual harassment toward any members or the public will be tolerated under any circumstance.
7. No alcohol or controlled substance consumption before or during a meeting will be tolerated under any circumstance at an Obsidian event.
8. Firearms will only be uncased or removed from the holster in a designated safe area or shooting bench. Loading and unloading all weapons will be done in the safe areas.
9. It is your responsibility to know and understand how to operate your firearm safely and ensure your firearm is in good working order.
10. Eye and Ear protection is mandatory for anyone entering the range.
11. Always keep the firearm action open, magazines removed and only load when ready to commence firing.
12. Always keep your finger high and off the trigger on the slide of the weapon until you are ready to commence fire.
13. Fire only when safe conditions exist: all shooters must face down range when handling a loaded firearm.
14. Always keep firearms pointed down range in a safe direction.
15. Do not pass firearms directly from person to person. Place the firearm on the bench or stable surface and allow the next person to pick it up.
16. If you are assigned a lane, remain in that lane and only shoot the target in that lane.
17. Do not transfer uncased firearms from lane to lane.
18. Use only commercially purchased paper targets that are properly placed in front of the shooter stall or stable target stand.
19. Use only the correct ammunition for your firearm as recommended by the manufacturer.
20. Any firearm not carried concealed, in accordance with all state and local laws, must be transported unloaded in a case or bag to or from the range.
21. Upon the command “CEASE FIRE”, stop all shooting immediately, put down your firearm and back away from the firing line. Shooters may not re-approach the firing line or pick up any firearm until an Obsidian Range Safety Officer gives the “all clear” signal.
22. Food, drink, gum or any tobacco product is not permitted on the range.
23. Always remember to wash your hands after you leave the range prior to eating.
24. If you observe any unsafe conditions, please report them to a range safety officer immediately. Act responsibly always.
25. Any violation of the code of conduct may result in immediate removal from the range and forfeiture of Membership.
Primary Member's Name

First NameLast Name
Primary Member's Signature

Clear
Date Signed

MonthDayYear
Date
Additional Member's Name (Spouse or Significant Other)

First NameLast Name
Additional Member's Signature

Clear
Date Signed

MonthDayYear
Date

PHOTO RELEASE FORM FOR PRIMARY MEMBER
I, blanks , as a member of Obsidian Sportsman and Defense Club (here after referred to as Obsidian), do hereby grant permission and consent for Obsidian to use photographs taken at any Obsidian function for presentation under any legal condition, including but not limited to: publicity, copyright purposes, illustration, recruitment, and web content:

IF YOU DO NOT CONSENT, SKIP TO THE LAST QUESTION BELOW.
I understand that there shall be no payment for this release.

I understand.
I understand that no royalty, fee, or other compensation shall become payable to me by reason of such use.

I understand.
I understand that I may revoke this authorization at any time by notifying the organization in writing. The revocation will not affect any actions taken before the receipt of this written notification.

I understand.
I understand and agree to the terms and conditions.

I understand.
I DO NOT grant permission and consent for Obsidian to use photographs taken of me at any Obsidian function.

I DO NOT consent.
Primary Member's Name

First NameLast Name
Primary Member's Signature

Clear
Date Signed

MonthDayYear
Date

PHOTO RELEASE FORM

for SPOUSE or SIGNIFICANT OTHER
I, blanks , as a member of Obsidian Sportsman and Defense Club (here after referred to as Obsidian), do hereby grant permission and consent for Obsidian to use photographs taken at any Obsidian function for presentation under any legal condition, including but not limited to: publicity, copyright purposes, illustration, recruitment, and web content:

IF YOU DO NOT CONSENT, SKIP TO THE LAST QUESTION BELOW.
I understand that there shall be no payment for this release.

I understand.
I understand that no royalty, fee, or other compensation shall become payable to me by reason of such use.

I understand.
I understand that I may revoke this authorization at any time by notifying the organization in writing. The revocation will not affect any actions taken before the receipt of this written notification.

I understand.
I understand and agree to the terms and conditions.

I understand.
I DO NOT grant permission and consent for Obsidian to use photographs taken of me at any Obsidian function.

I DO NOT consent.
Spouse or Significant Other's Name

First NameLast Name
Additional Member's Signature

Clear
Date Signed

MonthDayYear
Date

NAAGA WAIVER OF LIABILITY, ASSUMPTION OF RISK, INDEMNIFICATION, AND HOLD HARMLESS AGREEMENT

for PRIMARY MEMBER

I have voluntarily agreed to participate in a course of instruction in the use of firearms or other shooting I hereby acknowledge the risks and dangers that exist in my use of any and all firearms and/or defensive tactics and techniques related to my participation in shooting activities. I understand and acknowledge that shooting activities are inherently dangerous and involve both known and unanticipated risks which could result in damage or destruction of property and physical or emotional injury, including, without limitation, paralysis, death, or damage to myself, to property, or to third parties. The risks include, but are not limited to, flying bullets, flying debris, noise, being shot by another, shooting myself or others; partial or total loss of eyesight or hearing; inhalation or other harmful contact with lead or other contaminants; burns and scarring; and being struck by flying or falling objects. I fully understand that participation in these dangerous shooting activities is voluntary and I agree to and do assume these risks. I acknowledge that this list is not inclusive of all possible risks associated with my participation in these shooting activities and that this list in no way limits the extent of this Waiver of Liability, Assumption of Risk, Indemnification, and Hold Harmless Agreement.

I hereby acknowledge and agree that at all times I will abide by all NAAGA range rules; all procedures enforced by the NAAGA Range Safety Officers; and all range rules of any shooting range at which NAAGA is presenting a course of instruction in the use of firearms or other shooting activity. In consideration for the course of instruction in the use of firearms; use of a shooting range, other facility, or land for such instruction; observation; and other training and services of NAAGA, its instructors, officers, directors, employees, members, and agents, I hereby fully acknowledge, understand, and agree to release, and, on behalf of myself, my heirs, representatives, executors, administrators, and assigns hereby do release NAAGA, its instructors, officers, directors, employees, members, and agents from any and all claims, demands, or causes of action of which I, my heirs, representatives, executors, administrators, or assigns may now have or have in the future against NAAGA, its instructors, officers, directors, employees, members, and agents on account of personal injury, property damage, death, or accident of any kind, arising out of or in any way related to the course of instruction in the use of firearms or other shooting activity provided by NAAGA, its instructors, officers, directors, employees, members, and agents, or my use of any equipment, shooting ranges or other facilities in connection with the course of instruction or shooting activity, and however the injury or damage is caused, including, but not limited to, any alleged negligence of NAAGA, its instructors, officers, directors, employees, members, and agents. I further agree that I will not bring a civil action against NAAGA, its instructors, officers, directors, employees, members, and agents based upon any of the foregoing. I understand that I will be solely responsible for any loss or damage including, but not limited to, death or paralysis, that I may sustain while participating in a NAAGA course of instruction in the use or firearms or other shooting activity, and that by signing this Agreement, I relieve NAAGA, its instructors, officers, directors, employees, members, and agents of any and all liability for such loss, damage or death.

I do hereby further agree to indemnify and hold harmless NAAGA, its instructors, officers, directors, employees, members, and agents from any and all claims, demands, damages, expenses, causes of action, attachments of property, liability, injury, death, or financial compensation which may occur in the present or future related to my participation in any and all activities arising out of, related to, or connected with the discharge of firearms; my participation in the course of instruction in the use of firearms or other shooting activity; my presence on or use of any shooting ranges or other facilities used by NAAGA for its course of instruction in the use of firearms or other shooting activity; and any and all acts or omissions committed by me.

I expressly agree that this Waiver of Liability, Assumption of Risk, Indemnification, and Hold Harmless Agreement is intended to be as broad as is permitted by the laws of the state in which NAAGA is presenting a course of instruction in the use of firearms or other shooting activity. I further agree that if any provisions of this agreement are held to be invalid, nevertheless, the balance of the agreement shall continue in full force and effect. I have had sufficient opportunity to read this Waiver of Liability, Assumption of Risk, Indemnification, and Hold Harmless Agreement and fully understand its terms. I understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing this agreement freely and voluntarily and intend my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.
Participant's Signature

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Date Signed

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Date
Participant's Name

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Address

Street Address

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CityState / Province

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Phone Number
Please enter a valid phone number.
If Participant is under 18 years old: Parent/Guardian Consent

I, as parent or guardian of the above minor under 18 years of age, hereby consent, on behalf of the said minor, to the terms and conditions set forth in this Waiver of Liability, Assumption of Risk, Indemnification, and Hold Harmless Agreement.
Parent/Guardian Signature

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Parent/Guardian Name

First NameLast Name

NAAGA WAIVER OF LIABILITY, ASSUMPTION OF RISK, INDEMNIFICATION, AND HOLD HARMLESS AGREEMENT

for SPOUSE or SIGNIFICANT OTHER

I have voluntarily agreed to participate in a course of instruction in the use of firearms or other shooting I hereby acknowledge the risks and dangers that exist in my use of any and all firearms and/or defensive tactics and techniques related to my participation in shooting activities. I understand and acknowledge that shooting activities are inherently dangerous and involve both known and unanticipated risks which could result in damage or destruction of property and physical or emotional injury, including, without limitation, paralysis, death, or damage to myself, to property, or to third parties. The risks include, but are not limited to, flying bullets, flying debris, noise, being shot by another, shooting myself or others; partial or total loss of eyesight or hearing; inhalation or other harmful contact with lead or other contaminants; burns and scarring; and being struck by flying or falling objects. I fully understand that participation in these dangerous shooting activities is voluntary and I agree to and do assume these risks. I acknowledge that this list is not inclusive of all possible risks associated with my participation in these shooting activities and that this list in no way limits the extent of this Waiver of Liability, Assumption of Risk, Indemnification, and Hold Harmless Agreement.

I hereby acknowledge and agree that at all times I will abide by all NAAGA range rules; all procedures enforced by the NAAGA Range Safety Officers; and all range rules of any shooting range at which NAAGA is presenting a course of instruction in the use of firearms or other shooting activity. In consideration for the course of instruction in the use of firearms; use of a shooting range, other facility, or land for such instruction; observation; and other training and services of NAAGA, its instructors, officers, directors, employees, members, and agents, I hereby fully acknowledge, understand, and agree to release, and, on behalf of myself, my heirs, representatives, executors, administrators, and assigns hereby do release NAAGA, its instructors, officers, directors, employees, members, and agents from any and all claims, demands, or causes of action of which I, my heirs, representatives, executors, administrators, or assigns may now have or have in the future against NAAGA, its instructors, officers, directors, employees, members, and agents on account of personal injury, property damage, death, or accident of any kind, arising out of or in any way related to the course of instruction in the use of firearms or other shooting activity provided by NAAGA, its instructors, officers, directors, employees, members, and agents, or my use of any equipment, shooting ranges or other facilities in connection with the course of instruction or shooting activity, and however the injury or damage is caused, including, but not limited to, any alleged negligence of NAAGA, its instructors, officers, directors, employees, members, and agents. I further agree that I will not bring a civil action against NAAGA, its instructors, officers, directors, employees, members, and agents based upon any of the foregoing. I understand that I will be solely responsible for any loss or damage including, but not limited to, death or paralysis, that I may sustain while participating in a NAAGA course of instruction in the use or firearms or other shooting activity, and that by signing this Agreement, I relieve NAAGA, its instructors, officers, directors, employees, members, and agents of any and all liability for such loss, damage or death.

I do hereby further agree to indemnify and hold harmless NAAGA, its instructors, officers, directors, employees, members, and agents from any and all claims, demands, damages, expenses, causes of action, attachments of property, liability, injury, death, or financial compensation which may occur in the present or future related to my participation in any and all activities arising out of, related to, or connected with the discharge of firearms; my participation in the course of instruction in the use of firearms or other shooting activity; my presence on or use of any shooting ranges or other facilities used by NAAGA for its course of instruction in the use of firearms or other shooting activity; and any and all acts or omissions committed by me.

I expressly agree that this Waiver of Liability, Assumption of Risk, Indemnification, and Hold Harmless Agreement is intended to be as broad as is permitted by the laws of the state in which NAAGA is presenting a course of instruction in the use of firearms or other shooting activity. I further agree that if any provisions of this agreement are held to be invalid, nevertheless, the balance of the agreement shall continue in full force and effect. I have had sufficient opportunity to read this Waiver of Liability, Assumption of Risk, Indemnification, and Hold Harmless Agreement and fully understand its terms. I understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing this agreement freely and voluntarily and intend my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.
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If Participant is under 18 years old: Parent/Guardian Consent

I, as parent or guardian of the above minor under 18 years of age, hereby consent, on behalf of the said minor, to the terms and conditions set forth in this Waiver of Liability, Assumption of Risk, Indemnification, and Hold Harmless Agreement.
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