Waiver of Liability and Hold Harmless

East Grand Forks Rod & Gun Club Privacy Statement

The East Grand Forks Rod & Gun Club (known hereafter as EGFRGC) collects personally identifiable information to verify the identity of prospective members as well as existing members for legal purposes. Personally identifiable information may include, but is not limited to I.P. address, date of birth, physical address, e-mail address, phone number and drivers license I.D. The EGFRGC respects the privacy of its members and prospective members and therefore does not share or sell said information to third parties. While said information is visible to Executive Members of the Board of Directors, the EGFRGC will not disclose said information to any individual or entity, internal or external of the EGFRGC unless compelled to do so by a court of law. The EGFRGC will also use said information to contact you about news/events and other information pertinent to the Club.

Privacy Statement*

By checking this box, I acknowledge the Privacy Statement above.

Club Waiver

Name*

First NameMiddle InitiialLast Name

Physical Address: (No P.O. Box) *

Street Address

Street Address Line 2

CityState/Province/Territory

Zip CodeCountry

Date of Birth*

Example: 06-10-1980

Phone Number:*

Phone Type:*

HomeMobile

E-mail*

Confirmation Email

Drivers License Number*

Drivers License Number

State Issued In*

Vehicle License Plate#*

All vehicles that will be used at the range must be listed.

The East Grand Forks Rod & Gun Club (EGFRGC) requires that all Guests and Members read and accept our Waiver of Liability and Hold Harmless Agreement. Please acknowledge the terms of the waiver agreement by entering your initials after every paragraph and signing at the end.

1. In consideration for receiving permission to participate in firearms training/qualification and / or to use the facilities of East Grand Forks Rod & Gun Club (Known hereafter as the EGFRGC)(the “Activities”), I hereby release, waive, discharge and indemnify EGFRGC or its officers, members or employees (“Releasees” ) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, injury, or death that may be sustained by me while participating in Activities, or on the EGFRGC’s premises, weather caused by the negligence of the Releasees or otherwise.

Enter Initials to acknowledge paragraph 1*

2. I am fully aware of the risks involved and hazards connected with the Activities including the risk of injury or death. I elect to voluntarily participate in those Activities with full knowledge that they may be hazardous to me and my property. I voluntarily assume the risk of loss, property damage, personal injury and /or death that may be sustained by me or my heirs and assigns as a result of my engaging in such Activities, whether caused by the negligence of Releasees or otherwise.

Enter Initials to acknowledge paragraph 2*

3. I further hereby agree to indemnify, defend, and hold harmless the Releasees from any loss, liability, damage or costs, including court costs and attorney fees, that they may incur due to my participation in the Activities, whether caused by the contributory negligence of Releasees or otherwise.

Enter Initials to acknowledge paragraph 3*

4. I am aware that I should review my own personal insurance coverage as no such losses or liability will be covered by any insurance maintained by the EGFRGC.

Enter Initials to acknowledge paragraph 4*

5. I understand that if I am participating in the Activities as a member of an organization, a Certificate of Insurance is required from each organization showing policy liability limits that are equal or greater than $1,000,000 and naming EGFRGC as an Additional Insured on each policy and each Certificate of Insurance naming these requirements will be provided to the EGFRGC before an organization participates in any activity on the premises of the EGFRGC.

Enter Initials to acknowledge paragraph 5*

6. I understand that this Waiver of Liability and Hold Harmless Agreement binds the members of my family and spouse if I am alive, and my heirs, assigns and personal representative if I am deceased and shall be deemed as a release, waiver, discharge and covenant not to sue the above-named Releasees and as an agreement to indemnify, defend and hold the EGFRGC harmless against any claims. This Agreement shall be construed in accordance with the laws of the State of Minnesota.

Enter Initials to acknowledge paragraph 6*

By entering my name below, I acknowledge and represent that I have read the foregoing Waiver of Liability and Hold Harmless Agreement, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this release for full, adequate and complete consideration fully intending to be bound by it.

Digital Signature*

First and Last Name

If you are applying for a Family Membership enter names of Family Members here:

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