General Waiver of Liability


Phone: 847-731-7898
41666 N SHERIDAN RD, ZION, IL 60099

AGREEMENT, RELEASE, INDEMNIFICATION, COVENANT NOT TO SUE AND WAIVER OF LIABILITY
(READ CAREFULLY BEFORE SIGNING. THIS IS A WAIVER OF YOUR LEGAL RIGHTS)

In the consideration of using this facility, herein after “Hartford Outdoors (DBA) 5 Star Firearms”, the undersigned, herein after “GUEST”, agrees to assume the risk and waives all liability of injury and right to sue. Use of this facility, directly or as a spectator, (herein after “activity”) includes but is not limited to: any class, competition, firearm rental, ammo purchase, firearm purchase, firing range rental, or training.

The GUEST is required to follow all safety rules written and verbal. 5 Star Firearms’ rules are posted, and the GUEST is given opportunity to ask for clarification of these rules. Any negligence or violation of these rules may result in ejection or banning from 5 Star Firearms’ premises with or without refund of purchase(s) made.

The GUEST agrees to abide by the safety rules set forth by 5 Star Firearms, as well as any Federal or State laws governing the use and transportation of firearms. The signing of this document is representation that the GUEST understands the rules and laws and agrees to act in a safe manner while on the premises of 5 Star Firearms.

The GUEST swears under the penalty of perjury that all information provided on this document is true and accurate.

Possession or use of a firearm by a convicted felon is prohibited by law and Hartford Outdoors (DBA) 5 Star Firearms will fully cooperate with any and all Federal and State authorities with the investigation and prosecution of such crimes. The GUEST may not allow the accompaniment of a convicted felon to the range as it is prohibited by law. Any GUEST who aids in such act is also at risk and liable for prosecution.

The GUEST releases, holds harmless and discharges Hartford Outdoors & 5 Star Firearms of and from all liabilities, claims, actions, damages, and costs of litigation/arbitration of any nature arising from any activity on the 5 Star Firearms premises. The GUEST also releases, holds harmless, and discharges 5 Star Firearms parent, related, affiliated, and subsidiary companies, as well as their officers, directors, employees, agents, representatives, insurers, successors, heirs and assignees of each.

The GUEST understands that the provisions of this agreement clearly and unequivocally include and apply to any claims of negligence (whether active or passive), bodily injury, death, property damage or loss as result of participation in any activity taking place at 5 Star Firearms. The GUEST agrees to pay 5 Star Firearms for any damage to the facility or any individual made directly, indirectly or incidentally by the GUEST. This Agreement grants 5 Star Firearms right to receive said payment through GUEST’s heirs, executors and administrators. Damages to facility or any individual includes but is not limited to property, personal injury, cleaning costs, loss of use, interruption of business, goodwill or reputation, medical costs, counseling costs, legal fees or attorney’s fees.

ARE YOU A CONVICTED FELON?
ARE YOU UNDER THE INFLUENCE OF ALCOHOL OR A CONTROLLED SUBSTANCE?
ARE YOU SUICIDAL OR DEPRESSED?
HAVE YOU BEEN ISSUED A RESTRAINING ORDER FOR ACTS OF DOMESTIC VIOLENCE?
HAVE YOU EVER BEEN ADJUDGED MENTALLY INCOMPETENT?
ARE YOU PREGNANT OR NURSING?
HAVE YOU EVER HANDLED A HANDGUN?
HAVE YOU EVER HANDLED A RIFLE?
HAVE YOU EVER HANDLED A SHOTGUN?
DO YOU REGULARLY PRACTICE WITH A FIREARM?
I HAVE WATCHED THE NSSF RANGE SAFETY VIDEO PROVIDED.

I certify that I am eighteen (18) years of age or older and that I am entering into this agreement on my own behalf. I expressly understand that the aforementioned activity includes the discharge of firearms and the firing of live ammunition. I further certify that I have completely read the foregoing and I expressly agree to all of the provisions of this agreement.

Name:

Date of Birth:

Address:
 

Phone #:

Email:
 

Drivers License:

If Illinois Resident, FOID #:
 

 

 

Leave this empty:

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Signature Certificate
Document name: General Waiver of Liability
lock iconUnique Document ID: 74e8102684bab83a623a4abb06823329222298d3
Timestamp Audit
May 15, 2020 3:16 pm CDTGeneral Waiver of Liability Uploaded by 5 Star Firearms - range@5starrange.com IP 72.133.156.87
May 17, 2020 1:15 pm CDT Document owner admin@5starfirearms.com has handed over this document to range@5starfirearms.com 2020-05-17 13:15:42 - 73.74.41.3
July 13, 2020 5:50 pm CDT Document owner range@5starfirearms.com has handed over this document to waiver@5starfirearms.com 2020-07-13 17:50:24 - 73.74.41.3
July 13, 2020 5:50 pm CDT Document owner waiver@5starfirearms.com has handed over this document to range@5starfirearms.com 2020-07-13 17:50:53 - 73.74.41.3
July 13, 2020 5:54 pm CDT Document owner range@5starfirearms.com has handed over this document to waiver@5starfirearms.com 2020-07-13 17:54:13 - 73.74.41.3
July 13, 2020 5:54 pm CDT Document owner waiver@5starfirearms.com has handed over this document to range@5starfirearms.com 2020-07-13 17:54:46 - 73.74.41.3