MWP Property & Gun Range Guest Liability and Publicity Waiver

MY WARRIOR'S PLACE, ITS PROGRAMS, the R&R PROPERTY & GUN RANGE

RELEASE, WAIVER OF LIABILITY, INDEMNIFICATION, HOLD HARMLESS, AND THE ASSUMPTION OF THE RISK AGREEMENT
I understand that if I decline to execute this document or disagree with any release, waiver of liability, indemnification, hold harmless, and the assumption of the risk agreement document statements, that I will not be permitted onto the premises of the My Warrior's Place property and Gun Range located at 32020 Oil Well Road, Punta Gorda, FL 33955

CAUTION: THIS IS A WAIVER OF LIABILITY. READ BEFORE SIGNING.

WHEREAS, in consideration for instruction in firearms, and in consideration for the use and enjoyment of The My Warrior's Place, Inc.’ s property, gun range facilities, and any and all related premises (collectively, the “MWP Property & Range”) for recreational, entertainment, training, or educational purposes, and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, and further recognizing the voluntary nature of such entry, use, and enjoyment of the 12.5 acre MWP Property and Range, the undersigned person ACKNOWLEDGES, UNDERSTANDS, AND AGREES to the following:
The undersigned, intending to be legally bound, hereby waives, abandons, gives up, and releases for myself and my accompanying family members, including any minors, as well as our respective guardians, beneficiaries, heirs, executors, administrators, legal representatives, and any other persons on their behalf, any and all rights, claims, demands, causes of action, and the like for injuries (to person or property), damages, wrongful death, and loss of services attributable to any cause, including negligence and willful acts, which such person may have against My Warrior's Place, Inc., and any of its board members, owners, agents, volunteers and employees, including their representatives, successors, and assigns while the undersigned is at the MWP Property & Range. The undersigned understands and acknowledges that such risks cannot be eliminated without compromising the essential qualities of shooting and any related activities.*

I agreeI disagree
Further, the undersigned expressly, knowingly, and voluntarily assumes the risks of accidents or damages, including death, involved in engaging in the activities offered at MWP Property & Range. The undersigned understands and expressly acknowledges that (a) risks and dangers exist in the use and observation of firearms, ammunition, explosives, and related equipment; and (b) participation in such activities and/or use of such equipment may result in injury or illness including, but not limited to, bodily injury, strains, fractures, partial and/or total paralysis, hearing loss, eye injury, blindness, heat stroke, heart attack, lead contamination, and other ailments that could cause serious bodily injury, disability, or death. The undersigned understands that this assumption of risk agreement shall remain in effect until the undersigned provides a written notice of cancellation by certified mail to My Warrior's Place, Inc. at the mailing address of 3269 Duncan Rd. #11, Punta Gorda, FL 33982*

I agreeI disagree
I agreeI disagree
I agreeI disagree
The undersigned agrees that My Warrior's Place, Inc., as well as any press or private parties present, have all rights to use the undersigned’s photograph, image, or likeness, provided that such photograph, image, or likeness is taken while on MWP Property & Range. This use includes publishing in magazines, advertising, videos, internet websites, or the like, so long as it is not altered to show other than actual activities in a way that could be harmful to the undersigned’s character. The undersigned forfeits any rights to civil action or claims in any use of such photograph, image, or likeness as described above. All photographs and images taken on the MWP Property & Range remain the property of My Warrior's Place, Inc. and may not be used or reproduced without the express written permission of the board members, staff, or management of My Warrior's Place, Inc.*

I agreeI disagree
I agreeI disagree
I agreeI disagree
THE UNDERSIGNED AGREES to assume all responsibility and liability for any act or acts, even any negligent, reckless or criminal act or omission to act, of the undersigned’s Guests at the MWP Property & Range (“Guests” includes any and all persons who are not associated with My Warrior's Place, Inc., who enter on to the MWP Property & Range, use the MWP Property & Range facilities or engage in or observe shooting and other activities at the MWP Property & Range as a result of my express invitation, permission or consent). Each of the undersigned’s Guests will read and sign a “RELEASE, WAIVER OF LIABILITY, INDEMNIFICATION, HOLD HARMLESS, AND ASSUMPTION OF THE RISK AGREEMENT.”*

I agreeI disagree
Participant's Legal Name (First & Last)*
John Doe
Participant's E-mail*
Participant's Phone Number*
Include area code
Participant's Date of Birth*
month/day/year
Participant's Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Military Service MemberLaw Enforcement OfficerFirefighterVeteranLaw Enforcement (Retired)Firefighter (Retired)Blue Star Family MemberLEO Family MemberFirefighter Family MemberGold Star Family MemberRed Star Family MemberGUEST of an American HeroCivilianOther
Name (First & Last) of Emergency Contact:*
Emergency Contact Phone:*
Emergency Contact is:*
Yes, I have been vetted & have my cardNo, I will need to be vetted upon arrivalNo, I will just be a guest of an American HeroNo, I am a civilian
If you are going to be a guest of an American Hero, please give us their name:
*Note: If bringing any minor children (under the age of 18) with you, you must be their parent or legal guardian and provide the name and age of all children you will be bringing to MWP Property & Range.
Legal Name of Minor Child:
Age:
Legal Name of Minor Child:
Age:
Legal Name of Minor Child:
Age:
Legal Name of Minor Child:
Age:
Legal Name of Minor Child:
Age:
LIABILITY AND PUBLICITY RELEASE FOR MINOR CHILDREN: I understand and agree to hereby release My Warrior's Place, Inc. and its Programs, Directors, Officers, Employees, Agents, Representatives and Volunteers, and each of them, and any related parties from any and all claims for injury, death or property damage suffered by any of the minor children listed above either as a willing participant or as a spectator throughout an activity or event that was conducted by or made possible by the efforts of My Warrior's Place and/or any of its programs and any of its “Parties Released” as stated above, even if such is caused by the negligence or fault of the “Parties Released”. Also, I understand that videotaping and/or photography may occur during our time out at the MWP Property & Range. I understand that My Warrior's Place & its programs may use such material in future publicity, on the website, and/or in additional outlets for educational and/or promotional efforts. I consent to any minor children with me, as listed above, having their voice and/or image recorded or photographed for use as outlined above. I am legally able to waive these rights for the minor children listed above who will be with me, and I am personally responsible for them.*

YesNoI am not bringing any minors
ELECTRONIC SIGNATURE CONSENT: By checking "I agree" below, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request a paper copy instead. By checking "I agree" below, you are also waiving that right. After consent, you may, upon written request to us, obtain a paper copy of this electronic record. No fee will be charged for such a copy, and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing, by certified mail, to the address of My Warrior's Place, Inc., located at 3269 Duncan Road #11 Punta Gorda, FL 33982, that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure we have a current email address so we can contact you regarding any changes, if necessary.*

I agreeI disagree
Electronic Signature:*

Clear
Upon clicking "Submit Form" you will be re-directed to our My Warrior's Place donate page on our website where you can make a donation, if you are so inclind, to support My Warrior's Place and its Programs. You will receive a donation receipt by email to the email address you input when making your donation.

If you do not wish to make a donation at this time, you can explore our website or just leave the website page.

We look forward to having you as a guest in the near future.
Date Submitted*

MonthDayYear
My Warrior's Place and all of our Programs appreciates the sacrifice and service made by all of our American Heroes and their families.
Should be Empty:

MY WARRIOR'S PLACE, ITS PROGRAMS, the R&R PROPERTY & GUN RANGE