1. I certify as follows: (1) I am not currently and have never been the subject of a criminal or any other proceeding that prevents me from legally owning, handling or possessing firearms under New Jersey or Federal law; (2) that I can lawfully own, handle and possess a firearm; and, (3) that all information given on this form is true and correct.
2. In consideration for being given access to Recoil's Range and/or equipment, the undersigned, for himself or herself and his or her heirs, executors and administrators, releases, waives, discharges and covenants not to sue Recoil and each of its members, officers, managers, employees and agents for any and all liability, daims, demands, actions and causes of action whatsoever for personal injury or property damage arising out of the use of the equipment and/or facilities of Recoil and agrees to hold Recoil free, dear and harmless and indemnify Recoil from and against any responsibility for any and all claims, demands, actions and causes of action for personal injury or property damage, loss or injury, including death, that may be sustained by the undersigned, whether caused by the negligence of the Releases or otherwise, arising out of all such use.
3. I am familiar with and understand the operation of each firearm (rifle, handgun, shotgun) which I will use at Recoil. I understand the range commands "cease fire" and "clear firearms" and will comply with same.
4. I accept full and complete responsibility for the inherent risk resulting from my own or anyone else's reloaded ammunition, including all responsibility for bodily injuries to myself and anyone else. I agree to thoroughly check to be sure I am using the correct ammunition at all times.
5. I acknowledge and fully understand that I and all others engaged in shooting. coaching, observing or training with firearms at Recoil will be engaged in activities that involve inherent risks of serious bodily injury including disability or death and severe social and economic losses which might result from my actions or inaction or the actions of others.
6. I accept full responsibility for any damage or destruction I cause to Recoil property, whether accidental, negligent, willful or otherwise. Recoil property includes, but is not limited to, the facility, range equipment, target frames, target supports or mechanisms, firearms, signs, and all equipment, electrical and otherwise. Recoil reserves the right to recover from me a reasonable charge for any such damage and is entitled to recover its costs, including reasonable attorney's fees, incurred in bringing any claim for such damages.
7. On behalf of myself, my heirs, executors, administrators and assigns, I hereby assume all risk of personal injury, disability or death. The word "damages includes, but is not limited to, the incurring of any physical and emotional injury of any kind, loss of physical function, ability or capacity, medical expenses, lost wages or income, loss of consortium and any other compensatory damage.
8. On behalf of myself, my heirs, executors, administrators and assigns, I hereby waive, release and discharge Recoil and its affiliates, and each of their officers, directors, owners (members), managers, employees, agents, successor' and assigns ("Released Parties") from any and all claims, demands, actions, or lawsuits seeking damages on account of any personal injury, disability or death occurring to myself or anyone else, caused in whole or in part or alleged to be so caused by the negligence of any of the released Parties or caused by anyone else.
9. On behalf of myself, my heirs, executors, administrators and assigns, I hereby agree to indemnify and defend the Released Parties from any and all claims, demands, actions or lawsuits for any personal injury, disability or death occurring to myself or any other person which result entirely or in part from the actions, failure to act, or negligence of myself, my guests or minors for whom I am responsible.
10. I agree that this Agreement shall be interpreted according to New Jersey law and that any dispute shall be resolved exclusively in state courts located in the State of New Jersey.
11. Membership in the Recoil facility will be available to persons who are legally able to possess a firearm. Recoil Members must be in compliance at all times with all federal, state and local laws and regulations concerning ownership and handling of firearms. Memberships will be granted, and may be revoked, at the sole discretion of Recoil.
12. Recoil reserves the right to refuse, suspend or revoke service, access to the facility or access to classroom instruction, to any individual or individuals, at any time.
13. I certify that I am neither impaired nor under the influence of alcohol, marijuana or any depressant, stimulant, or narcotic drug or any other controlled dangerous substance.
14. I certify that do not possess any physical, mental, visual, or auditory impairment that would prevent me from safely operating a firearm.
15. In the event I bring a minor to Recoil, the attached Guardian's release, Assumption of Risk and Indemnity Agreement has been signed by the minor's legal guardian.
16. I recognize the safety of everyone at Recoil is my responsibility and I agree not to cause harm to myself or others at Recoil.
17. I agree to immediately report any death, injury, property damage, whether intentional, reckless, or negligent to the Recoil staff.
18. I agree to immediately report any reckless, negligent or otherwise dangerous behavior to the Recoil staff.
19. I hereby verify and confirm that I, the actual signer of this Agreement, am an adult over the age of 18 years, that I have read and initialed each of the above terms, and conditions, that I understand everything set forth above and that I have knowingly given up substantial legal rights by signing below, which I do voluntarily.
In consideration for being given access to the Recoil facility and/or equipment, the undersigned, for himself or herself and his or her heirs, executors and administrators, RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE Recoil, and each of its members, officers, managers, employees and agents, for any and all liability, claims, demands, actions and causes of action whatsoever for personal injury or property damage arising out of the use of the equipment and/or facilities of Recoil, or arising from the negligence of Recoil, and agrees to hold Recoil free, clear and harmless and indemnify Recoil from and against any responsibility for any and all claims, demands, actions and causes of action for personal injury or property damage, loss or injury, including death, that may be sustained by the undersigned, whether caused by the negligence of Recoil or otherwise, arising out of all such use of Recoil's property and facility. I acknowledge that as a condition to Recoil allowing me to access the Recoil facility and/or equipment I will also sign this Agreement.
I have read the above range safety rules (reverse page) and understand the range safety rules for Recoil's training facility and range. I have watched the NSSF *Range safety and Etiquette* video. I will fully comply with all of the above safety rules. Recoil's range safety rules are subject to change for operational, legal or safety reasons.