2024 PRGC Liability Release Form and Responsible Person Questionnaire (combined into one as of 2024-01-11)

These forms are to be filled by every shooting member of each family membership of the Paradise Rod & Gun Club (PRGC), including those18 years of age and under. (All PRGC memberships are family memberships). Parents should complete copies of this Release for their minor children.

NOTE: Once the first person has submitted this form, the next person can either clear the form and proceed, or simply change relevant fields to reflect their own information.

Please also request a copy of your responses if desired.


A reminder about digital signatures

When signed online, your typed name on this form is acceptable as your legal signature. Note that you also have the option of signing a hardcopy version of this form, in person, at the December 2023 General Meeting or at the range prior to sunset on December 31st, 2023. Turn that form in to the Webmaster (Dennis Barrett). (At the range, give your completed hardcopy forms to your RSO to be conveyed to Dennis.)

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2024 PRGC Liability Release Form

This Liability Release is valid for the calendar year of 2024. (Section 2 below is your 2024 Responsible Person Questionnaire. )

Both forms must be filled in and signed. (We're hoping putting the two forms together gets that idea across a little better that both forms are required.)

Ready? Here we go.

Email address for the individual signing below (even if it's you! If your email appears above, it's to tell YOU that you're logged in under that email address; it doesn't appear for us.) If you would: *

I hereby expressly acknowledge that the use of firearms is an inherently dangerous activity and that being present where firearms are being discharged is also an inherently dangerous activity. I further expressly acknowledge that I have read the following Club Documents: PRGC Bylaws, PRGC Policies and Procedures, and the Range Operations Manual. I affirm that I understand my responsibilities while at the range, and warrant that I will comply with all range rules and the directions of Range Safety Officers.

*

With full knowledge, understanding, and awareness of the dangers inherent in the activities occurring on or within the facilities of the Paradise Rod and Gun Club, and in consideration of being granted permission to use the private facilities of the Paradise Rod and Gun Club, I hereby voluntarily assume full responsibility for all risks of any kind whatsoever, whether or not arising from the negligence of Paradise Rod and Gun Club, Inc., its agents, officers, members, employees, successors and assigns (hereinafter referred to in total as PRGC) or myself , and fully release, waive, and forever discharge PRGC, from any and all liability of every kind for any personal injury, property damage, or death suffered by me arising from or by reason of my participation in any activity sponsored by PRGC or arising from or by reason of my use of or presence upon the PRGC facilities.

*
I further intend that my free and voluntary waiver and release of PRGC be binding upon my spouse, heirs, executors, successors, and assigns, and that it be interpreted as broadly and inclusively as permitted by law. Should any claim, demand, or lawsuit arise or be asserted in any way whatsoever related to my use of, or presence upon, the PRGC’s facilities, I shall indemnify, defend, and hold harmless PRGC from any and all costs, expenses, or liability, including but not limited to the cost of any settlement or judgment together with all costs of court and other costs or expenses incurred by PRGC in connection therewith, including attorney’s fees.
*

I hereby grant permission to PRGC to administer any first aid or other medical treatment or service that may be necessary in the event of my injury, and do hereby hold PRGC free from any and all liability arising in any manner from any first aid, medical treatment or service rendered me.

*
I have carefully read this Release and understand its meaning and terms. I execute this Release voluntarily with full knowledge of its significance. Should a court of competent jurisdiction hold any portion of this voluntary release invalid or unenforceable, I intend the remainder to continue in full force and effect. *
Please enter the information requested below, including your typed signature at the end.
Your PRGC membership #: *
Number of people in this family membership. (A family membership extends to everyone living at the same address who is either one of the responsible adults or is a dependent under 18. If your situation is more "creative" than this, contact the Membership Chair at membership@ThePRGClub.org to discuss how to address this form.) *
Your PRGC membership expiration date: *
Your age (or the age of the under-18 person named). *
Mailing address: your street number or P.O. Box number *
Mailing address: your city, state, and zip code *
Your phone #: *
Your NRA membership #: *
Your NRA membership type: *
Your NRA membership expiration date (if Lifetime, leave this blank):
If you have one, your NRA RSO expiration date:
And, finally, your typed name signifying your agreement with the 2024 Liability Release portion of this document. *
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