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 firearms, 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 conditions, 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.

VOLUNTARY PARTICIPATION. 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 knowledge 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.

INSURANCE AND PROPERTY DAMAGE. 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 conscious decision to fire.
4. Be sure of your target, its foreground and background before firing.
5. Do not attempt to catch a dropped firearm.
6. Only discharge a firearm as directed during the training session.

I HEREBY CERTIFY ALL OF THE FOLLOWING:

• I am physically and psychologically fit to participate in this Activity, have no condition or medication that would impair my safe participation, and I am not under the influence of alcohol, drugs, or any other substance that could impair my judgment or reaction time. I agree to inform the Instructor of any condition that may affect my performance or the safety of others prior to the start of any Activity.
• I agree to use my best judgment in undertaking these Activities, to faithfully adhere to all safety instructions and recommendations, and to follow all range commands and Instructor directives immediately and without hesitation.
• I agree that if the Instructor believes I am involved in any suspicious, criminal, or anti-government extremist behavior or affiliations, I may be removed from the Activity without refund.
• I am at least 18 years of age. I understand that participation is not permitted for anyone under 18 years of age under any circumstances.
• FEDERAL FIREARMS ELIGIBILITY: I hereby certify that I am legally eligible to possess and use firearms under all applicable federal and state laws, including but not limited to 18 U.S.C. § 922(g), and that I am not a prohibited person as defined thereunder. This includes persons convicted of any misdemeanor crime of domestic violence or subject to a qualifying domestic violence protective order. I understand that providing false information on this form may constitute a federal crime. I agree that PCA LLC bears no responsibility for any harm or liability arising from my participation if I have misrepresented my legal eligibility.
• ITAR COMPLIANCE & U.S. CITIZENSHIP/RESIDENCY REQUIREMENT: Participation in PCA LLC training activities is restricted to U.S. citizens and U.S. permanent residents (green card holders) only. This restriction is required by the International Traffic in Arms Regulations (ITAR), 22 C.F.R. Parts 120–130, which govern the transfer of defense-related services, technical data, and training to foreign persons, regardless of where such transfer takes place. I hereby certify that I am either: (a) a United States citizen by birth or naturalization, or (b) a lawful permanent resident of the United States. I understand that I may be required to provide documentation of my status prior to participation. I understand that any misrepresentation of my citizenship or residency status is a violation of federal law and that PCA LLC will not be liable for any consequences arising from my false certification.
• MEDIA RELEASE: I understand that training activities conducted by PCA LLC may be recorded via audio and/or video surveillance. I hereby grant PCA LLC the irrevocable right to use any photographs, video, or audio recordings in which I appear for training, marketing, promotional, and educational purposes, without compensation to me. I waive any right to inspect or approve the finished product.

RELEASE AND INDEMNIFICATION. 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 reasonable attorneys' 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 further understand that other participants in the Activity are present at their own risk. In the event that my actions cause injury to another participant or third party, I agree to indemnify and hold harmless PCA LLC from any resulting claim, demand, or legal action.

COVENANT NOT TO SUE. 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.

ARBITRATION. Any controversy or claim arising out of or relating to this Agreement, or the breach thereof, shall be determined by final and binding arbitration administered 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-appealable 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 pursue a legal right.  The arbitrator will have no authority to award punitive damages or consequential damages. Any judicial proceeding to enforce an arbitration award or compel arbitration shall be brought exclusively in the state or federal courts located in Montgomery County, Ohio, and I hereby consent to the personal jurisdiction of those courts.

EQUIPMENT — OWNED, LOANED, AND THIRD-PARTY. I understand that during Activities I may use firearms, ammunition, or equipment owned by PCA LLC, by the Instructor, or by other participants ("Loaned Equipment"). I hereby assume full and sole responsibility for my safe handling and use of any and all Loaned Equipment, whether such equipment is provided to me for the duration of a class, offered to me to try on a temporary basis, or made available by another participant. PCA LLC makes no warranty, express or implied, regarding the condition, fitness, or safety of any Loaned Equipment. I have independently inspected or had the opportunity to inspect any Loaned Equipment prior to use and accept it in its present condition. PCA LLC shall not be liable for any injury, damage, or malfunction arising from my use of Loaned Equipment, regardless of the source of that equipment. In the event that I damage any Loaned Equipment through misuse, negligence, or failure to follow instructions, I agree to be responsible for the full replacement cost of such equipment, to be paid within ten (10) days of the occurrence. If I bring personally owned firearms, ammunition, or equipment to any Activity, I assume full responsibility for the safe condition and lawful ownership of such items, and I agree to indemnify PCA LLC from any claim arising from the use or malfunction of my personally owned equipment by myself or any other participant.

EMERGENCY MEDICAL AUTHORIZATION. In the event of injury or medical emergency, I authorize PCA LLC and its Instructors to seek or facilitate emergency medical treatment on my behalf. I agree that PCA LLC shall not be liable for any medical decisions made in good faith during an emergency situation. I acknowledge that I am responsible for all costs associated with any emergency medical care I receive.

GOVERNING LAW. This Agreement shall be governed by and construed in accordance with the laws of the State of Ohio, without regard to its conflict of law provisions.

SEVERABILITY. If any provision of this Agreement is determined to be invalid, illegal, or unenforceable, the remaining provisions shall continue in full force and effect. The parties agree that the invalid or unenforceable provision shall be modified to the minimum extent necessary to make it valid and enforceable.

DURATION, MODIFICATION, AND ENTIRE AGREEMENT. I understand and agree that this Agreement is effective upon signature. This Agreement is evergreen and shall remain in full force and effect indefinitely, covering all present and future Activities, classes, training sessions, and events in which I participate with PCA LLC, without the need to execute a new agreement for each session. I acknowledge that it is my responsibility to notify PCA LLC in writing if my eligibility status under any certification in this Agreement changes, including but not limited to changes in my legal eligibility to possess firearms or my citizenship/residency status. PCA LLC reserves the right to update or modify this Agreement at any time. In the event of material changes, PCA LLC may notify me via the email address provided, and my continued participation in any Activity following such notice shall constitute my acceptance of the updated terms. This Agreement may be executed electronically, and my electronic signature shall be deemed valid and binding pursuant to the Electronic Signatures in Global and National Commerce Act (E-SIGN), 15 U.S.C. § 7001 et seq. This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements. No modification shall be valid unless made in writing and signed by an authorized representative of PCA LLC.

I HEREBY CERTIFY THAT I AM A COMPETENT ADULT AND HAVE CAREFULLY READ AND CLEARLY UNDERSTAND THIS ENTIRE AGREEMENT, INCLUDING ALL ELIGIBILITY CERTIFICATIONS, AND AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE PCA LLC BY SIGNING THIS AGREEMENT. I FURTHER CERTIFY THAT ALL INFORMATION AND CERTIFICATIONS PROVIDED HEREIN ARE TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE.

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