• RANGE USE CERTIFICATION

    RANGE USE CERTIFICATION

    LIABILITY WAIVER AND RELEASE APPLICATION
  • Membership with MCWCC includes unsupervised access to Club Ranges.  To promote a safe environment, all members must complete an Application annually comprised of passing a safety exam, completing this Certification, Release and Waiver document, and having attended a safety briefing within the time frame specified by the MCWCC Board of Directors. 

    Whether applying as a new candidate, or renewing your membership at MCWCC, please complete this form in its entirety.  This document is key component of your Application which is required for unsupervised access to our Club and Range facilities.

    Each Applicant must read and understand the on-line Safety Brief, pass the related Exam (requires a score of at least 90% correct responses), participate in an in-person briefing, and pay all applicable fees/dues.  Immediate family members over the age of 18 and living at your address, may also obtain unsupervised access to our facilities as part of your membership.  If family members are included in the membership,  complete the applicable sections of the Application for registering each individual seeking unsupervised access.  NOTE: To be granted unsupervised access to the Club and Ranges, each individual must read and understand the on-line Safety Brief, pass the related Exam, and participate in an in-person briefing.

    For existing Members, your renewal Application and your dues payment must be received by the MCWCC Club by February 28th of each year. Incomplete Applications or dues received after this date will be subject to an additional administrative fee.  After April 15th, you must reapply as a new applicant. 

    Applications are incomplete without passing the on-line safety exam, signing and submitting this document, having attended an in-person  briefing, and paying any dues or fees owed.  An incomplete Application will result in loss of unsupervised access to the property.

    The fields with a red asterisk are required.  We request you pay dues using our on-line system; this will promote timely recording of your payment.  Secured payment links are provided on our website.  Should you elect to pay by check, please, bring your payment to our monthly members' meeting. 

    The Club's mailing address is:  MCWCC, P.O. BOX 272, Lakeview, NC 28350.

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  • Format: (000) 000-0000.
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  • Certification /Liability Waiver /Release

    • I hearby certify that I qualify for membership in the Moore County Wildlife Conservation Club by meeting the published prerequisites for such membership.
    • I hearby certify by my signature that I have no criminal convictions that prevent me from legally possessing, owning or purchasing firearms.
    • I further certify that I am not illegally or unlawfully in the United States.
    • I further certify that I have not been (nor am I pending) dishonorably discharged from the Armed Forces.
    • I further certify that I have not renounced my United States citizenship.
    • I further certify that I am not an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance.
    • I further certify that I will always take personal responsibility to act in a safe manner, both for myself and my guests, when participating in activities on the Moore County Wildlife Conservation Club ("MCWCC") property.
    • I further certify that I have no official or unofficial history of mental illness or substance abuse; and
    • I further certify I have never been affiliated with or belonged to any gang or other illegal organization involved or engaged in any illegal activities. This includes international or domestic terrorist organizations.
    • I understand that all MCWCC matches and training programs depend upon the careful control of each match participation/student and the match participation/student’s cooperation. If the match participation/student’s conduct is not deemed satisfactory, then at the sole discretion of the MCWCC Representative, the participation/student will be asked to leave the property.
    • I will abide by all the safety procedures and rules of conduct promulgated by Moore County Wildlife and Conservation Club, Inc. ("the Club") and I agree to unconditionally release the Club of any and all liability for injury or loss I may sustain while on or using the Club property, equipment and facilities.
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    Participation Acknowledgement
    I, the undersigned, by signing this form (the “Agreement”), hereby acknowledge that I am a member, or family member of a member,(collectively, “Member”) of the Moore County Wildlife and Conservation Club, Inc., a North Carolina non-profit corporation(hereafter “MCWCC”). As such, MCWCC affords me opportunities to engage in various MCWCC activities, use MCWCC facilities and/or equipment, as well as offering me opportunities to volunteer, organize, direct and/or serve in various capacities with MCWCC (collectively referenced as “Activities” or “Activity”). Such Activities may involve the use of firearms, archery equipment and/or physical exercise, including without limitation, target shooting (with rifles, pistols, shotguns, crossbows, bows or otherweapons), hunting, hiking, land navigation, boating and similar outdoor activities. In consideration of these opportunities afforded meby MCWCC, I agree to abide by MCWCC Rules, Regulations and By-Laws duly adopted, from time to time, by the MCWCC Board of Directors.
     
    Risk Acknowledgement, Indemnity and Release
    I fully understand that I may injure myself, or suffer injury, as a result of my participation in Activities and that certain injuries may result indeath or permanent physical disability. In consideration of the opportunities afforded me by membership in the MCWCC, I hereby assumeall risks, known and unknown, associated with participation in such Activities including, but not limited to, any injuries resulting from firearms, archery equipment, other weapons, falls, contact with other participants, and the conditions of MCWCC facilities, Activity sitesand equipment, to include bodily injuries, permanent disabilities, and death. To the fullest extent permitted by law, I hereby agree toindemnify and hold harmless and defend the MCWCC, its employees, organizers, volunteers, directors, representatives, agents and/orofficers, (a.k.a. the “Indemnified Parties) from and against any and all claims, losses, damages, expenses and other liabilities (including,but not limited to, court costs, expert witness fees and attorney’s fees) arising out of and/or resulting in whole or in part from my participation in such Activities. I for myself and anyone entitled to act on my behalf, including, but not limited to my heirs, assigns andsuccessors, hereby RELEASE, WAIVE AND FOREVER DISHARGE the Indemnified Parties from any and  all claims, losses, damages,expenses and other liabilities of any kind arising out of my participation in Activities, even if such claims, losses, damages, expenses and/orother liabilities arise out of the negligence or carelessness on the part of any or  all of the Indemnified Parties. Furthermore, I covenant not tosue and not to file any legal action, lawsuit or other petition for judicial determination of my rights with respect to claims I might otherwisehave against the Indemnified Parties at any time, other than for specific willfully tortious act(s) and, in such case, only with respect tothe specific person(s) whose willfully tortious act(s) caused me damage.
     
    Media Release
    I hereby grant and convey to MCWCC all right, title and interest I may have in any and all photographs, motion pictures, video recordings,and any other recordings made during or about the Activity, and MCWCC shall have the right to exploit such recordings throughout theuniverse, an unlimited number of times, in perpetuity by any and all means and media, no known or hereafter invented.


    Medical Emergencies
    I hereby give permission to the MCWCC, its employees, organizers, volunteers, directors, representatives, agents and/or officers (hereafter,“MCWCC Parties”) to contact emergency services for help, whether or not the MCWCC Parties have contacted my emergency contact and give permission to a licensed physician or other licensed medical provider to provide proper treatment, including but not limited tohospitalization, injection, anesthesia and/or surgery. I hereby RELEASE, WAIVE AND FOREVER DISCHARGE the MCWCC Parties from any and all claims, liabilities, causes of action, damages, demands, judgments, executions, liens and costs whatsoever in law orequity, including, without limitation, liability for death or bodily injuries to any person or damage to any property resulting from any (i) claims made against medical providers of emergency services under this authorization, or (ii) against the MCWCC Parties for obtainingemergency medical services for me pursuant to this authorization and waiver.
     

    Privacy Policy
    MCWCC collects nonpublic, personal information about its Members only in connection with services provided to the Members.  MCWCC will not sell or intentionally disclose nonpublic personal information about its Members to third parties except as required or permitted by law, in compliance to a court ruling or as authorized by the Member.


    Venue/Jurisdiction/Construction/Severability
    This Agreement shall be governed and construed in accordance with the laws of the State of North Carolina, and any dispute that may later arise with respect to any term or provision of this Agreement shall be resolved in the General Court of Justice, Moore County, North Carolina, it being my clear intent to consent to such jurisdiction and venue. Should any portion of this Agreement require judicial interpretation, I agree that the Court or Tribunal construing the same shall not apply a presumption that terms hereof shall be more strictly construed against any oneparty by reason of the rule of construction that a document is to be more strictly construed against the party who prepared the document. If any provision of this Agreement is held to be invalid or unenforceable, all other provisions shall nevertheless continue in full force andeffect. By signing this Agreement, I agree that I have read it, that I understand its contents, and that I act voluntarily in executing it.

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    Final Step

    TO COMPLETE THIS APPLICATION, YOU MUST CLICK ON THE GREEN "Submit Member Application" BUTTON BELOW.

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