Please complete the form below and sign in order to participate.

THIS IS A RELEASE OF LIABILITY AND A WAIVER OF CERTAIN LEGAL RIGHTS.

The  undersigned (referred to as "I" or "me") in consideration to participate in the training ("Activity" or "Activities") provided by Providence Consulting & Associates LLC ("PCA LLC"), and the intangible value that I will gain by participating in the Activity, I agree to all of the terms and conditions set forth in this agreement ("Agreement").

I am aware and understand that handling and shooting fiearms, live fire training, physical exercise, other training activities, or the use of techniques or strategies taught have inherent risks, hazards, and dangers that cannot be eliminated. 

I UNDERSTAND THAT THESE RISKS, HAZARDS, AND DANGERS INCLUDE BUT ARE NOT LIMITED TO:

• The risk of handling firearms and being near others handling firearms.
• The risk of hearing damage from noise as well as other potential injuries.
• The risk of injury from ammunition, ricochets, fragments, and other projectiles.
• The risk of injury compounded by negligent emergency response.
• The risk of inclement weather, austere condtions, and rugged terrain.
• The risk of encounters with wildlife, animals, and insects.
• The risk of exposure to hazardous materials, chemicals, or compounds.
• The risk of criminal and/or civil liability.
• The risk of injury, serious injury, or death.

I understand the risks, hazards, and dangers of the use of firearms, participating in firearms handling and related training Activities.  I understand that these Activities are dangerous and may require good physical conditioning, mental capability, and a degree of skill and knowledge.  My participation in this Activity is purely voluntary.  No one is forcing me to participate, and I elect to participate with full knowlege of and despite the risks.

I AM VOLUNTARILY USING THE SERVICES OF PCA LLC, WITH FULL KNOWLEDGE OF THE INHERENT RISKS, HAZARDS, AND DANGERS INVOLVED AND HEREBY ASSUME AND ACCEPT ANY AND ALL RISKS OF INJURY, PARALYSIS, DEATH, OR PROPERTY DAMAGE, WHETHER CAUSED BY MY NEGLIGENCE, THE NEGLIGENCE OF OTHERS, OR THE NEGLIGENCE OF PCA LLC.

I confirm that I either have specific insurance to cover any injuries that I may sustain, damage that I may cause, or that I have chosen to participate in the Activities without any insurance coverage and agree to assume full responsibility of risk and bodily injury, death, and property damage. I understand that I am solely responsible for the full replacement cost of any damaged property to be paid to the owner within ten (10) days of the occurrence. 

I hereby assume all risks, known and unknown, which may arise from my decision to participate in these Activities.

I UNDERSTAND AND AGREE TO ABIDE BY THESE FIREARM SAFETY RULES:

1. Treat all firearms as if they are always loaded all of the time.
2. Never allow the muzzle to point at anything you're not willing to destroy or kill.
3. Keep your finger off the trigger and outside the trigger guard until you are on target and have made the concious decision to fire.
4. Be sure of your target, it's foreground and backgroud before firing.
5. Do not attempt to catch a dropped firearm.

I HEREBY CERTIFY ALL OF THE FOLLOWING:

• I am physically and psychologically fit to participate in this Activity.
• I agree to use my best judgement in undertaking these Activities, to use and to faithfully adhere to any and all safety instructions or recomendations.
• I agree to follow all safety instructions and understand that I may be removed from the Activity, without refund, if I fail to do so.
• I agree that if the Instructor believes I am involved in any suspicious or criminal behavior I may be removed from the Activity, without refund.
• I understand the Activity area(s) may be under audio and video surveillance and that my actions and activities may be recorded. I also release the use of such images or recordings by PCA LLC for training and marketing purposes.
• I can legally participate in these activities, and can legally own or posses a firearm.
• I am not a fugitive from justice, under indictment or convicted of a felony or offense involving illegal possession, use or trafficking in any drugs of abuse.
• I am not drug dependant, a chronic alcoholic, not under adjudication for mental incompetence, or convicted of Domestic Violence.
• I am not a foreign national prohibited from receiving this training and/or material under ITAR Regulations.
• I am not participating in this Activity in association or in support of subversive or quasi-subversive organizations or activities aimed at the United States of America or its citizens, whether within or beyond U.S. borders.
• I am at least 18 years of age or the signature of my parent or legal guardian appears below.

I , for myself, my heirs, successors, executors, and subrogates, hereby expressly waive and release any and all claims, now known or hereafter known in any jurisdiction throughout the world, against PCA LLC, and its officers, directors, employees, agents, volunteers, affiliates, members, successors and assigns (collectively, "Releasees"), on account of injury, death or property damage arising out of or attributable to my participation in the Activities, whether arising out of the negligence of PCA LLC or any Releasees or otherwise.  I covenant not to make or bring any such claim against PCA LLC or any other Releasee, and forever release and discharge PCA LLC and all other Releasees from liability under such claims, I shall defend, indemnify and hold harmless PCA LLC and all other Releasees against any and all damages, liabilities, deficiencies, claims, actions, judgements, settlements, interests, awards, penalties, fines, costs, or expenses of whatever kind, including reasonably attorney fees, that are incurred by the indemnified party, arising out of or related to any third-party claim alleging any bodily injury, death of any person or damage to real or tangible personal property caused by my negligence or other more culpable act or omission (including reckless or willful misconduct) in connection with my participation in the Activities.

I, for myself, my heirs, my successors, executors, and subrogates, further agree not to sue PCA LLC or any other Releasee as a result of any injury, paralysis, or death suffered in connection with my use and participation in the Activities.

Any controversy or claim arising out of or relating to this Agreement, or the breach thereof, shall be determined by final and binding arbitration adminstered by the American Arbitration Association ("AAA") under its Commercial Arbitration Rules and Mediation Procedures ("Commercial Rules").  There shall be one arbitrator agreed to by the parties within twenty (20) days of receipt by respondent of the request for arbitration, or in default thereof appointed by the AAA in accordance with its Commercial Rules.  The award rendered by the arbitrator shall be final, non-reviewable, and non-appelable and binding on the parties and may be entered and enforced in any court having jurisdiction.  The place of arbitration shall be Montgomery County, Ohio.  Except as may be required by law neither a party nor the arbitrator may disclose the existence, content, or results of any arbitration without the prior written consent of both parties, unless to protect or pusue a legal right.  The arbitrator will have no authority to award punitive damages or consequential damages.

I understand and agree that this Agreement is effective upon signature, and may not be revoked, altered, amended, rescinded, or voided without the express prior written consent of PCA LLC.

I HEREBY CERTIFY THAT I AM A COMPETENT ADULT AND HAVE CAREFULLY READ, CLEARLY UNDERSTAND, AND AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE PCA LLC BY SIGNING THIS AGREEMENT.

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If the participant is under 18 years of age, a signature of approval is needed from the parent/guardian.