Fall-2026 WCSS SCTP Registration

Warren County Shooting Sports

SCTP and SASP Registration
Athlete Information
Athlete’s Name

First NameLast Name
Athlete’s Primary Address

Street Address

Street Address Line 2

CityState

Zip Code
Athlete’s Phone Number
If the athlete does not have a phone number, enter the primary parent/guardian’s phone number.Format: (000) 000-0000.
Athlete’s Email
Do not use the athlete’s school-issued email address. School email systems may block messages related to shooting sports. If the athlete does not have a personal email address, enter the primary parent/guardian’s email address.
Athlete’s Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Athlete’s Current School
Athlete’s Graduation Year
Did you participate in the Spring of 2026?

Parent or Guardian Information

Parent Contact and Emergency Contact info.
Primary Parent/Guardian Name

First NameLast Name
Primary Parent/Guardian Email
example@example.com
Primary Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Parent/Guardian Name

First NameLast Name
Secondary Parent/Guardian Email
example@example.com
Secondary Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact 1

First NameLast Name
Emergency Contact 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact 2

First NameLast Name
Emergency Contact 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Medical Information
Date of Last Tetanus or DTaP Vaccination

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Does your child have any food, medication or environmental allergies?
Please describe allergies.
Please list any known medical conditions, such as asthma, seizures, or heart conditions.
Please list any required medications.
Insurance Company
Policy Number
Primary Physician
Primary Physician Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Preferred Hospital for Emergency Care

Waiver and Release
WAIVER AND RELEASE AGREEMENT

Participation and Covered Activities: In consideration for permission to participate in Warren County Shotgun Sports (“WCSS”), the participant and parent/legal guardian acknowledge that participation may include firearm and shotgun instruction, training, practices, competitions, fundraising activities, team events, travel, and transportation associated with WCSS activities.

Acknowledgment of Risks: Shooting sports and related activities involve inherent and other reasonably foreseeable risks, including firearm handling by the participant and others; ammunition, shot, fragments, targets, spent hulls, and equipment malfunction or misuse; slips, falls, uneven terrain, physical exertion, weather and environmental exposure; hearing or eye injury; transportation in passenger vehicles, UTVs, and golf carts; and acts or omissions of participants, spectators, volunteers, facility operators, and other third parties. These risks may result in serious injury, illness, disability, property damage, or death.

Voluntary Participation and Assumption of Risk: Participation is voluntary. The participant and parent/legal guardian confirm that they have had an opportunity to ask questions and that the participant is physically and mentally able to participate safely, subject to any restrictions disclosed to WCSS and any reasonable accommodations agreed upon. The participant and parent/legal guardian knowingly and voluntarily accept and assume the inherent and reasonably foreseeable risks associated with participation.

Release and Hold Harmless: To the fullest extent permitted by Iowa law, the participant and parent/legal guardian release and hold harmless WCSS and its directors, officers, coaches, volunteers, employees, agents, sponsors, host facilities, and affiliated organizations from claims, demands, damages, losses, liabilities, and expenses arising from or related to participation, including claims based on ordinary negligence. This agreement does not release liability for gross negligence, reckless or intentional misconduct, or any claim that cannot lawfully be waived.

Limited Indemnification: To the fullest extent permitted by Iowa law, the participant and parent/legal guardian agree to indemnify and hold harmless the released parties from third-party claims or losses caused by the participant’s own acts, violation of safety rules or instructions, or misuse of firearms or other equipment. This provision does not require indemnification for gross negligence, reckless or intentional misconduct by a released party, or any matter that cannot lawfully be indemnified.

Emergency Medical Authorization: If an injury or medical emergency occurs and a parent/legal guardian cannot be reached promptly, the parent/legal guardian authorizes WCSS representatives to contact emergency services and obtain reasonably necessary medical care for the participant. WCSS does not guarantee that medical personnel or treatment will be available. The participant and family remain responsible for resulting medical expenses.

Rules and Safety Instructions: The participant agrees to follow all WCSS safety policies, governing-program rules, host-range rules, and instructions from coaches and range personnel. A violation may result in immediate removal from an activity and may also result in suspension or dismissal from WCSS.

Iowa Law and Severability: This agreement is governed by Iowa law. If any provision is found invalid or unenforceable, it will be limited or severed only to the minimum extent necessary, and the remaining provisions will continue in effect.

Acknowledgment: By signing below, the participant and parent/legal guardian confirm that they have read and understand this agreement, have had the opportunity to ask questions, are signing voluntarily, and understand that this agreement affects legal rights. Nothing in this agreement is intended to waive any right or claim that cannot lawfully be waived on behalf of an adult or minor participant.
Athlete’s Waiver Signature
Parent/Guardian Waiver Signature

MEDIA RELEASE FORM
By checking and signing below, I give Warren County Shotgun Sports (WCSS) and its governing bodies permission to use my child’s name, photo, likeness, and statements for promotional purposes. This includes use in print, online, advertising, and other media.

I waive all rights to approve or receive compensation and release WCSS, its directors, officers, staff, and volunteers from any claims related to privacy, publicity, defamation, or copyright arising from this use.
Media Release Agreement
Parent/Guardian Media Release Signature

Handbook Review

Please read and discuss with your student the WCSS handbook prior to signing. The rules and guidelines affect both parent and student.
By signing below, you confirm that you have read and understand the WCSS Handbook.
Athlete’s Handbook Signature
Parent/Guardian Handbook Signature

Warren County Shotgun Sports – Mental Health and Safety Disclosure Agreement
MENTAL HEALTH AND SAFETY DISCLOSURE AND PARTICIPATION POLICY

1. Purpose

WCSS is committed to safe firearm participation and to supporting participants. This policy is based on behavior and individualized safety concerns, not merely on a diagnosis, disability, treatment history, or a request for accommodation.

2. Scope and Effective Period

This policy applies to safety-related incidents during the six months before registration and throughout participation with WCSS.

3. Required Disclosure

A participant or parent/legal guardian must promptly disclose suicide threats or ideation involving a credible safety concern, self-harm or attempted self-harm, credible threats or acts of harm toward others, or hospitalization or mental-health watch specifically connected to a risk of harm to self or others. This policy does not require disclosure of unrelated diagnoses, counseling, medication, or private treatment details.

4. Good-Faith Reports

A coach, peer, school official, healthcare professional, or other person may report a specific safety concern. A third-party report is treated as a concern to evaluate, not as proof of misconduct or automatic proof that the allegation is true.

5. Immediate Response

When WCSS reasonably believes there may be a current firearm-safety risk, it may impose a temporary safety suspension from practices, competitions, meetings involving firearms, and access to team firearms or ammunition while the board conducts a prompt individualized review. In an apparent emergency, WCSS may contact emergency services, law enforcement, or the participant’s parent/legal guardian.

6. Individualized Board Review

Designated board members will review the nature, recency, credibility, severity, and relationship of the concern to safe firearm participation. The participant and parent/legal guardian may provide relevant information. A diagnosis alone is not grounds for suspension. WCSS may consider reasonable safety accommodations where appropriate.

7. Reinstatement After a Substantiated Safety Concern

If a safety concern is substantiated, reinstatement may require evaluation and treatment by a licensed mental-health professional, at least eight consecutive weeks of therapy or treatment, and a signed clearance letter confirming that the professional has evaluated the participant, believes the participant can safely participate in shooting sports, and confirms compliance with the recommended treatment plan. The provider—not WCSS—determines the clinically appropriate treatment. WCSS will not request therapy notes, diagnoses, medication lists, or unrelated medical records.

8. Submission

Clearance documentation may be sent by certified mail or directly from the provider’s professional email domain. Documentation from unlicensed providers, life coaches, or persons lacking appropriate mental-health credentials is not accepted. For a minor, the parent/legal guardian must also provide written confirmation of compliance and consent to return.

9. Ongoing Safety

Reinstatement may include reasonable, written safety conditions and may be reconsidered if new safety concerns arise. Failure to disclose a required incident, refusal to comply with a temporary safety restriction, falsification, or failure to provide required clearance may result in continued or indefinite suspension until the safety requirements are satisfied.

10. Confidentiality

WCSS will collect only information reasonably necessary for safety review, restrict access to designated board members with a need to know, and store information securely. Information will not be disclosed except with written authorization or as reasonably necessary to address an imminent safety threat, comply with law, respond to legal process, or protect the participant or others. This policy does not promise absolute confidentiality.

11. Non-Retaliation and Non-Discrimination

Good-faith reports will not be used as a basis for retaliation. Knowingly false or malicious reports may result in discipline. Decisions under this policy are not based solely on disability, diagnosis, treatment, or medication and will be individualized.

12. Appeal

A participant or parent/legal guardian may submit a written appeal to the WCSS Board. When reasonably practicable, the appeal will be reviewed by board members not directly involved in the original decision. Supporting information may be submitted. A written response will be provided within a reasonable timeframe. Temporary safety restrictions remain in place during appeal unless the board determines otherwise.

13. Authorities

WCSS may contact appropriate authorities or make reports when it reasonably believes there is an imminent risk, when required by law, or when necessary to protect a participant or others.

14. Acknowledgment

By signing below, the participant and parent/legal guardian confirm that they have read and understood this policy, answered honestly, agree to comply, and understand that this is a safety policy rather than medical advice or a guarantee of safety.
By selecting this option and signing below, you confirm that you have read and understand the policy above and that no reportable incidents have occurred within the past six months.
Athlete’s Mental Health Signature
Parent/Guardian Mental Health Signature

Warren County Izaak Walton League Membership
Warren County Izaak Walton League Membership
Please list all family members, including the participating athlete, below. If you need to add more than five, please contact us at info@warrencountyss.org so we can manually add additional family members.
Family Member 1

First NameLast Name
Family Member 1 Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Family Member 2

First NameLast Name
Family Member 2 Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Family Member 3

First NameLast Name
Family Member 3 Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Family Member 4

First NameLast Name
Family Member 4 Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Family Member 5

First NameLast Name
Family Member 5 Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Financial Obligations
Registration for Fall 2026 closes on August 31, 2026. Families choosing payment in full will be invoiced after registration closes.

Monthly Installments

Four evenly distributed monthly payments: September, October, November, and December.

Singles is included with SCTP registration. Additional disciplines and shoots outside the scheduled events—four events in the fall and six events in the spring—will be billed to the athlete’s account.
Please Choose a Payment Method
Participation Fee
Izaak Walton Membership Adjustment
Volunteer Fee
Total Due
New Pioneer Gun Club Membership Fee
Disclaimer
WCSS participation fees must be paid at enrollment or according to the payment schedule selected during registration. These fees allow the team to secure range space, uniforms, competition entries, and required Iowa SCTP and ATA memberships. Because WCSS must commit participant numbers to host ranges and governing organizations before the season begins, all team fees are nonrefundable. Apparel, ammunition, and other items purchased through the team are also nonrefundable. Please verify all sizes, quantities, and ammunition types before ordering. By submitting a registration or placing an order, you acknowledge that you have read, understood, and accepted this refund policy.
By signing below, you agree to the total cost of the selections made above.
Should be Empty:

Warren County Shooting Sports

Athlete Information

Parent or Guardian Information

Medical Information

Waiver and Release

MEDIA RELEASE FORM

Handbook Review

Warren County Shotgun Sports – Mental Health and Safety Disclosure Agreement

Participation Selection

Volunteer Commitment

Warren County Izaak Walton League Membership

Financial Obligations

Disclaimer