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ASSUMPTION OF RISK, RELEASE & INDEMNITY AGREEMENT

RANGE RULES

FIREARM EXPERIENCE DISCLOSURE FORM


 

GRANITE STATE INDOOR RANGE & GUN SHOP, LLC

ASSUMPTION OF RISK, RELEASE & INDEMNITY AGREEMENT

In consideration of the undersigned being permitted to engage in Shooting Activities (as
hereinafter defined) or in the case of a parent or guardian of a minor, in consideration of my child or ward
being permitted to engage in Shooting Activities, on property leased by Granite State Indoor Range & Gun
Shop, LLC (hereinafter Granite State) and owned by GSIR Holdings, LLC (hereinafter GSIR)
located at 2 Hampshire Drive, Hudson, New Hampshire 03051 (the "Premises"), the undersigned,
on his or her behalf or on behalf of the undersigned's heirs, executors, administrators, personal
representatives, successors, and assigns (collectively, the "Undersigned") hereby acknowledges and agrees to
the following.

The Undersigned expressly assumes the risk of entering the Premises and taking part in Shooting
Activities on the Premises. Shooting Activities as used in this Agreement shall mean engaging in or
observing others shooting handguns, rifles, shotguns and other firearms, including the firing of live
ammunition; shooting sports training; shooting competitions; and any other use of or activity on the
Premises; including the land and buildings located thereon. The Undersigned acknowledges and understands
the inherent hazards involved in Shooting Activities, both known and unanticipated, which could result in
damage or destruction of personal property and physical or emotional injury, including paralysis or death of
the Undersigned or other persons. The risks include, but are not limited to: potentially fatal injury from the
use of firearms by the Undersigned or others; partial or total loss of eyesight or hearing; inhalation or other
harmful contact with lead or other contaminants; being struck by flying or ricocheting or falling objects. The
risks also include injury, fatal injury or property damage resulting from negligent emergency response or
rescue operations. The Undersigned acknowledges that such hazards and risks cannot be eliminated without
compromising the essential qualities of the Premises, equipment and Shooting Activities.

THE UNDERSIGNED AGREES TO ACCEPT AND ASSUME ANY AND ALL RISKS
EXISTING ON THE PREMISES AND IN ENTERING ON TO AND IN USING THE
SHOOTING RANGE AND OTHER FACILITIES ON THE PREMISES OR EQUIPMENT
OR AMMUNITION PROVIDED BY GRANITE STATE AND IN ENGAGING IN OR
OBSERVING SHOOTING, SHOOTING SPORTS TRAINING, SHOOTING COMPETITIONS,
OR OTHER SHOOTING ACTIVITIES AT THE PREMISES WHETHER CAUSED BY THE
NEGLIGENCE OF GRANITE STATE OR GSIR OR OTHERWISE.

The Undersigned agrees to accept and 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
Premises. The Undersigned's "Guests" shall include any and all persons who are not members of Granite
State who enter the Premises as a result of the Undersigned's invitation, permission, or consent.
The Undersigned agrees to indemnify, hold harmless and defend Granite State, GSIR, and any of
their respective employees, directors, officers, agents, and volunteers (and their heirs, executors,
trustees , and beneficiaries) from any and all fault, liabilities, costs (including cost of any settlement or
judgment , costs of court, and attorneys' fees), expenses, claims, demands, and lawsuits arising out of,
related to, or connected with the actions or omissions of the Undersigned, or of the Undersigned's
licensees, guests or invitees ("Guests"), occurring on or about the Premises, including, but not limited to,
participation in discharging firearms, observing the discharge of firearms, use of the shooting range,
buildings, land, or any other portion of the Premises.

The Undersigned hereby releases and forever discharges and agrees not to sue Granite
State, GSIR, or any of their respective employees, directors, officers, agents, and volunteers (and their
heirs, executors, trustees, and beneficiaries), for any and all claims, demands, damages, expenses,
causes of action, attachments of property, or liability of any kind whatsoever that arise from
property damage, personal or emotional injury, or death resulting from the Undersigned or the
Undersigned's Guests entering on to the Premises, using the shooting range or any other facilities
located on the Premises, or engaging in or observing shooting, shooting sports training, shooting
competitions, and other Shooting Activities at the Premises, even if such claims, demands, damages,
expenses, causes of action, attachments of property, or liability result partially or wholly from any
act or acts, even any negligent act or omission to act including, without limitation, negligent or omitted
firstaid or rescue operations or procedures, by Granite State, GSIR, or any of their respective
employees, directors, officers, agents, or volunteers.

The Undersigned acknowledges and agrees that he/she has read and understands and at all
times will abide by all Granite State rules and regulations, any rules or procedures applicable to
any particular activity, the procedures, safety rules, and any and all instructions of Granite States
employees, whether communicated in writing, verbally, or posted at the Premises. The Undersigned
further agrees that he/she will cause his/her Guests to abide by such rules and regulations as well.
APART FROM OTHER APPLICABLE RULES, THE UNDERSIGNED AND ALL GUESTS SHALL WEAR
APPROPRIATE EAR AND EYE PROTECTION AT ALL TIMES WHEN PARTICIPATING IN OR OBSERVING
SHOOTING ACTIVITIES.

This Agreement shall be interpreted and enforced under the laws of the State of New
Hampshire. The Agreement is intended to be as broad and inclusive as permitted by law. If any
provision or portion is held to be invalid, void, or otherwise unenforceable, the parties intend that
such provision or portion shall remain applicable to the fullest extent permitted by law, and the
remaining provisions or portion shall continue and remain in full force and effect. This Agreement,
along with any signed written amendments or modifications to it, shall remain in full force and effect
in perpetuity beginning on the date of execution and shall be applicable to each and every occasion
that the Undersigned or Guests enter on to the Premises.

If the Undersigned is a minor, a parent or legal guardian's signature agreeing to this
Agreement as to such minor must accompany the signature of the Undersigned. The Undersigned (if a
parent or legal guardian) hereby certifies that he or she has the legal right to consent to the within
Assumption of Risk, Release & Indemnity Agreement on behalf of the minor and to join in this
Agreement individually.

THE UNDERSIGNED ENTERS THIS AGREEMENT WILLINGLY, AND UNDERSTANDS
THAT BY THIS SIGNATURE THE UNDERSIGNED WAIVES SUBSTANTIAL RIGHTS, AGREEING
NOT TO SUE GRANITE STATEOR GSIR AND TO RELEASE AND HOLD GRANITE
STATE OR GSIR HARMLESS FROM ALL LIABILITY.

April 25, 2024

First Shooter's Name

First Name*

Middle Name

Last Name*

Phone*
First Shooter's Date of Birth*
First Shooter's FIREARMS EXPERIENCE DISCLOSURE
I rate my previous experience with HANDGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with RIFLES as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with SHOTGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
Have you ever been adjudicated or administratively determined to be mentally incompetent; been committed to or voluntarily enrolled in an institution for the treatment of mental illness or have a history of mental illness?*
Have you ever been convicted of a FELONY which has not been annulled, or are you otherwise prohibited from handling or possessing a firearm?*
Are you presently the subject of a court order or decree or other governmental order which prohibits you from possessing or handling firearms?*
Are you an unlawful user of or addicted to marijuana, depressants, stimulants, narcotic drugs or any other controlled or illegal substances?*
APPLICANT FURTHER AGREES TO BE HELD FINANCIALLY RESPONSIBLE FOR ANY DAMAGE OR DESTRUCTION TO THE SHOOTING RANGE OR THE PREMISES OF WHICH IT IS PART or for any personal injury or death or property damage resulting, in whole or in part, from the willful conduct or the negligent action or failure to act of the Applicant. Applicant also agrees to adhere to the firearms safety rules and acknowledges having read, understood and signed a copy of Granite State Indoor Range and Gun Shop LLC's Range Rules and agrees to adhere to said Range Rules. ANY DAMAGE DONE TO THE RANGE OR EQUIPMENT WILL RESULT IN A MINIMUM CHARGE OF $25.00 TO SAID APPLICANT UP TO THE FULL COST TO REPAIR OR REPLACE EQUIPMENT AT OUR SOLE DISCRETION. *
I AGREE
I DO NOT AGREE
First Shooter's Signature*
Second Shooter's Name

First Name*

Middle Name

Last Name*
Second Shooter's Date of Birth*
Second Shooter's FIREARMS EXPERIENCE DISCLOSURE
I rate my previous experience with HANDGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with RIFLES as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with SHOTGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
Have you ever been adjudicated or administratively determined to be mentally incompetent; been committed to or voluntarily enrolled in an institution for the treatment of mental illness or have a history of mental illness?*
Have you ever been convicted of a FELONY which has not been annulled, or are you otherwise prohibited from handling or possessing a firearm?*
Are you presently the subject of a court order or decree or other governmental order which prohibits you from possessing or handling firearms?*
Are you an unlawful user of or addicted to marijuana, depressants, stimulants, narcotic drugs or any other controlled or illegal substances?*
APPLICANT FURTHER AGREES TO BE HELD FINANCIALLY RESPONSIBLE FOR ANY DAMAGE OR DESTRUCTION TO THE SHOOTING RANGE OR THE PREMISES OF WHICH IT IS PART or for any personal injury or death or property damage resulting, in whole or in part, from the willful conduct or the negligent action or failure to act of the Applicant. Applicant also agrees to adhere to the firearms safety rules and acknowledges having read, understood and signed a copy of Granite State Indoor Range and Gun Shop LLC's Range Rules and agrees to adhere to said Range Rules. ANY DAMAGE DONE TO THE RANGE OR EQUIPMENT WILL RESULT IN A MINIMUM CHARGE OF $25.00 TO SAID APPLICANT UP TO THE FULL COST TO REPAIR OR REPLACE EQUIPMENT AT OUR SOLE DISCRETION. *
I AGREE
I DO NOT AGREE
Second Shooter's Signature*
Third Shooter's Name

First Name*

Middle Name

Last Name*
Third Shooter's Date of Birth*
Third Shooter's FIREARMS EXPERIENCE DISCLOSURE
I rate my previous experience with HANDGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with RIFLES as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with SHOTGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
Have you ever been adjudicated or administratively determined to be mentally incompetent; been committed to or voluntarily enrolled in an institution for the treatment of mental illness or have a history of mental illness?*
Have you ever been convicted of a FELONY which has not been annulled, or are you otherwise prohibited from handling or possessing a firearm?*
Are you presently the subject of a court order or decree or other governmental order which prohibits you from possessing or handling firearms?*
Are you an unlawful user of or addicted to marijuana, depressants, stimulants, narcotic drugs or any other controlled or illegal substances?*
APPLICANT FURTHER AGREES TO BE HELD FINANCIALLY RESPONSIBLE FOR ANY DAMAGE OR DESTRUCTION TO THE SHOOTING RANGE OR THE PREMISES OF WHICH IT IS PART or for any personal injury or death or property damage resulting, in whole or in part, from the willful conduct or the negligent action or failure to act of the Applicant. Applicant also agrees to adhere to the firearms safety rules and acknowledges having read, understood and signed a copy of Granite State Indoor Range and Gun Shop LLC's Range Rules and agrees to adhere to said Range Rules. ANY DAMAGE DONE TO THE RANGE OR EQUIPMENT WILL RESULT IN A MINIMUM CHARGE OF $25.00 TO SAID APPLICANT UP TO THE FULL COST TO REPAIR OR REPLACE EQUIPMENT AT OUR SOLE DISCRETION. *
I AGREE
I DO NOT AGREE
Third Shooter's Signature*
Fourth Shooter's Name

First Name*

Middle Name

Last Name*
Fourth Shooter's Date of Birth*
Fourth Shooter's FIREARMS EXPERIENCE DISCLOSURE
I rate my previous experience with HANDGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with RIFLES as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with SHOTGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
Have you ever been adjudicated or administratively determined to be mentally incompetent; been committed to or voluntarily enrolled in an institution for the treatment of mental illness or have a history of mental illness?*
Have you ever been convicted of a FELONY which has not been annulled, or are you otherwise prohibited from handling or possessing a firearm?*
Are you presently the subject of a court order or decree or other governmental order which prohibits you from possessing or handling firearms?*
Are you an unlawful user of or addicted to marijuana, depressants, stimulants, narcotic drugs or any other controlled or illegal substances?*
APPLICANT FURTHER AGREES TO BE HELD FINANCIALLY RESPONSIBLE FOR ANY DAMAGE OR DESTRUCTION TO THE SHOOTING RANGE OR THE PREMISES OF WHICH IT IS PART or for any personal injury or death or property damage resulting, in whole or in part, from the willful conduct or the negligent action or failure to act of the Applicant. Applicant also agrees to adhere to the firearms safety rules and acknowledges having read, understood and signed a copy of Granite State Indoor Range and Gun Shop LLC's Range Rules and agrees to adhere to said Range Rules. ANY DAMAGE DONE TO THE RANGE OR EQUIPMENT WILL RESULT IN A MINIMUM CHARGE OF $25.00 TO SAID APPLICANT UP TO THE FULL COST TO REPAIR OR REPLACE EQUIPMENT AT OUR SOLE DISCRETION. *
I AGREE
I DO NOT AGREE
Fourth Shooter's Signature*
Fifth Shooter's Name

First Name*

Middle Name

Last Name*
Fifth Shooter's Date of Birth*
Fifth Shooter's FIREARMS EXPERIENCE DISCLOSURE
I rate my previous experience with HANDGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with RIFLES as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with SHOTGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
Have you ever been adjudicated or administratively determined to be mentally incompetent; been committed to or voluntarily enrolled in an institution for the treatment of mental illness or have a history of mental illness?*
Have you ever been convicted of a FELONY which has not been annulled, or are you otherwise prohibited from handling or possessing a firearm?*
Are you presently the subject of a court order or decree or other governmental order which prohibits you from possessing or handling firearms?*
Are you an unlawful user of or addicted to marijuana, depressants, stimulants, narcotic drugs or any other controlled or illegal substances?*
APPLICANT FURTHER AGREES TO BE HELD FINANCIALLY RESPONSIBLE FOR ANY DAMAGE OR DESTRUCTION TO THE SHOOTING RANGE OR THE PREMISES OF WHICH IT IS PART or for any personal injury or death or property damage resulting, in whole or in part, from the willful conduct or the negligent action or failure to act of the Applicant. Applicant also agrees to adhere to the firearms safety rules and acknowledges having read, understood and signed a copy of Granite State Indoor Range and Gun Shop LLC's Range Rules and agrees to adhere to said Range Rules. ANY DAMAGE DONE TO THE RANGE OR EQUIPMENT WILL RESULT IN A MINIMUM CHARGE OF $25.00 TO SAID APPLICANT UP TO THE FULL COST TO REPAIR OR REPLACE EQUIPMENT AT OUR SOLE DISCRETION. *
I AGREE
I DO NOT AGREE
Fifth Shooter's Signature*
Sixth Shooter's Name

First Name*

Middle Name

Last Name*
Sixth Shooter's Date of Birth*
Sixth Shooter's FIREARMS EXPERIENCE DISCLOSURE
I rate my previous experience with HANDGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with RIFLES as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with SHOTGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
Have you ever been adjudicated or administratively determined to be mentally incompetent; been committed to or voluntarily enrolled in an institution for the treatment of mental illness or have a history of mental illness?*
Have you ever been convicted of a FELONY which has not been annulled, or are you otherwise prohibited from handling or possessing a firearm?*
Are you presently the subject of a court order or decree or other governmental order which prohibits you from possessing or handling firearms?*
Are you an unlawful user of or addicted to marijuana, depressants, stimulants, narcotic drugs or any other controlled or illegal substances?*
APPLICANT FURTHER AGREES TO BE HELD FINANCIALLY RESPONSIBLE FOR ANY DAMAGE OR DESTRUCTION TO THE SHOOTING RANGE OR THE PREMISES OF WHICH IT IS PART or for any personal injury or death or property damage resulting, in whole or in part, from the willful conduct or the negligent action or failure to act of the Applicant. Applicant also agrees to adhere to the firearms safety rules and acknowledges having read, understood and signed a copy of Granite State Indoor Range and Gun Shop LLC's Range Rules and agrees to adhere to said Range Rules. ANY DAMAGE DONE TO THE RANGE OR EQUIPMENT WILL RESULT IN A MINIMUM CHARGE OF $25.00 TO SAID APPLICANT UP TO THE FULL COST TO REPAIR OR REPLACE EQUIPMENT AT OUR SOLE DISCRETION. *
I AGREE
I DO NOT AGREE
Sixth Shooter's Signature*
Seventh Shooter's Name

First Name*

Middle Name

Last Name*
Seventh Shooter's Date of Birth*
Seventh Shooter's FIREARMS EXPERIENCE DISCLOSURE
I rate my previous experience with HANDGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with RIFLES as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with SHOTGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
Have you ever been adjudicated or administratively determined to be mentally incompetent; been committed to or voluntarily enrolled in an institution for the treatment of mental illness or have a history of mental illness?*
Have you ever been convicted of a FELONY which has not been annulled, or are you otherwise prohibited from handling or possessing a firearm?*
Are you presently the subject of a court order or decree or other governmental order which prohibits you from possessing or handling firearms?*
Are you an unlawful user of or addicted to marijuana, depressants, stimulants, narcotic drugs or any other controlled or illegal substances?*
APPLICANT FURTHER AGREES TO BE HELD FINANCIALLY RESPONSIBLE FOR ANY DAMAGE OR DESTRUCTION TO THE SHOOTING RANGE OR THE PREMISES OF WHICH IT IS PART or for any personal injury or death or property damage resulting, in whole or in part, from the willful conduct or the negligent action or failure to act of the Applicant. Applicant also agrees to adhere to the firearms safety rules and acknowledges having read, understood and signed a copy of Granite State Indoor Range and Gun Shop LLC's Range Rules and agrees to adhere to said Range Rules. ANY DAMAGE DONE TO THE RANGE OR EQUIPMENT WILL RESULT IN A MINIMUM CHARGE OF $25.00 TO SAID APPLICANT UP TO THE FULL COST TO REPAIR OR REPLACE EQUIPMENT AT OUR SOLE DISCRETION. *
I AGREE
I DO NOT AGREE
Seventh Shooter's Signature*
Eighth Shooter's Name

First Name*

Middle Name

Last Name*
Eighth Shooter's Date of Birth*
Eighth Shooter's FIREARMS EXPERIENCE DISCLOSURE
I rate my previous experience with HANDGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with RIFLES as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with SHOTGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
Have you ever been adjudicated or administratively determined to be mentally incompetent; been committed to or voluntarily enrolled in an institution for the treatment of mental illness or have a history of mental illness?*
Have you ever been convicted of a FELONY which has not been annulled, or are you otherwise prohibited from handling or possessing a firearm?*
Are you presently the subject of a court order or decree or other governmental order which prohibits you from possessing or handling firearms?*
Are you an unlawful user of or addicted to marijuana, depressants, stimulants, narcotic drugs or any other controlled or illegal substances?*
APPLICANT FURTHER AGREES TO BE HELD FINANCIALLY RESPONSIBLE FOR ANY DAMAGE OR DESTRUCTION TO THE SHOOTING RANGE OR THE PREMISES OF WHICH IT IS PART or for any personal injury or death or property damage resulting, in whole or in part, from the willful conduct or the negligent action or failure to act of the Applicant. Applicant also agrees to adhere to the firearms safety rules and acknowledges having read, understood and signed a copy of Granite State Indoor Range and Gun Shop LLC's Range Rules and agrees to adhere to said Range Rules. ANY DAMAGE DONE TO THE RANGE OR EQUIPMENT WILL RESULT IN A MINIMUM CHARGE OF $25.00 TO SAID APPLICANT UP TO THE FULL COST TO REPAIR OR REPLACE EQUIPMENT AT OUR SOLE DISCRETION. *
I AGREE
I DO NOT AGREE
Eighth Shooter's Signature*
Ninth Shooter's Name

First Name*

Middle Name

Last Name*
Ninth Shooter's Date of Birth*
Ninth Shooter's FIREARMS EXPERIENCE DISCLOSURE
I rate my previous experience with HANDGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with RIFLES as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with SHOTGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
Have you ever been adjudicated or administratively determined to be mentally incompetent; been committed to or voluntarily enrolled in an institution for the treatment of mental illness or have a history of mental illness?*
Have you ever been convicted of a FELONY which has not been annulled, or are you otherwise prohibited from handling or possessing a firearm?*
Are you presently the subject of a court order or decree or other governmental order which prohibits you from possessing or handling firearms?*
Are you an unlawful user of or addicted to marijuana, depressants, stimulants, narcotic drugs or any other controlled or illegal substances?*
APPLICANT FURTHER AGREES TO BE HELD FINANCIALLY RESPONSIBLE FOR ANY DAMAGE OR DESTRUCTION TO THE SHOOTING RANGE OR THE PREMISES OF WHICH IT IS PART or for any personal injury or death or property damage resulting, in whole or in part, from the willful conduct or the negligent action or failure to act of the Applicant. Applicant also agrees to adhere to the firearms safety rules and acknowledges having read, understood and signed a copy of Granite State Indoor Range and Gun Shop LLC's Range Rules and agrees to adhere to said Range Rules. ANY DAMAGE DONE TO THE RANGE OR EQUIPMENT WILL RESULT IN A MINIMUM CHARGE OF $25.00 TO SAID APPLICANT UP TO THE FULL COST TO REPAIR OR REPLACE EQUIPMENT AT OUR SOLE DISCRETION. *
I AGREE
I DO NOT AGREE
Ninth Shooter's Signature*
Tenth Shooter's Name

First Name*

Middle Name

Last Name*
Tenth Shooter's Date of Birth*
Tenth Shooter's FIREARMS EXPERIENCE DISCLOSURE
I rate my previous experience with HANDGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with RIFLES as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with SHOTGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
Have you ever been adjudicated or administratively determined to be mentally incompetent; been committed to or voluntarily enrolled in an institution for the treatment of mental illness or have a history of mental illness?*
Have you ever been convicted of a FELONY which has not been annulled, or are you otherwise prohibited from handling or possessing a firearm?*
Are you presently the subject of a court order or decree or other governmental order which prohibits you from possessing or handling firearms?*
Are you an unlawful user of or addicted to marijuana, depressants, stimulants, narcotic drugs or any other controlled or illegal substances?*
APPLICANT FURTHER AGREES TO BE HELD FINANCIALLY RESPONSIBLE FOR ANY DAMAGE OR DESTRUCTION TO THE SHOOTING RANGE OR THE PREMISES OF WHICH IT IS PART or for any personal injury or death or property damage resulting, in whole or in part, from the willful conduct or the negligent action or failure to act of the Applicant. Applicant also agrees to adhere to the firearms safety rules and acknowledges having read, understood and signed a copy of Granite State Indoor Range and Gun Shop LLC's Range Rules and agrees to adhere to said Range Rules. ANY DAMAGE DONE TO THE RANGE OR EQUIPMENT WILL RESULT IN A MINIMUM CHARGE OF $25.00 TO SAID APPLICANT UP TO THE FULL COST TO REPAIR OR REPLACE EQUIPMENT AT OUR SOLE DISCRETION. *
I AGREE
I DO NOT AGREE
Tenth Shooter's Signature*
Shooter's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
GSIR RANGE RULES
ALWAYS KEEP FIREARMS POINTED DOWNRANGE, NEVER TO THE SIDE OR REAR. *
I AGREE
KEEP YOUR FINGER OUT OF THE TRIGGER GUARD -AND OFF THE TRIGGER- UNTIL YOU HAVE THE FIREARM POINTED AT THE TARGET AND ARE READY TO FIRE *
I AGREE
WEAR YOUR EYE AND EAR PROTECTION AT ALL TIMES ON THE RANGE. NO EXCEPTIONS! *
I AGREE
HANDLE FIREARMS ONLY WHEN INSIDE THE FIRING BOOTH. FIREARMS MUST BE IN A CASE, CARRIER, HOLSTER, OR OTHER CONTAINER WHEN OUTSIDE THE BOOTH. *
I AGREE
KEEP FIREARMS UNLOADED, WITH THE ACTION OPEN, WHEN NOT IN USE *
I AGREE
POSITION YOUR FIREARM AT SHOULDER LEVEL, SUCH THAT YOU ARE FIRING HORIZONTALLY (BENCH-RESTING PISTOLS IS NOT ALLOWED). *
I AGREE
FIRE ONLY AT THE TARGET IN YOUR LANE - FIRING AT TARGETS IN OTHER LANES IS STRICTLY PROHIBITED. *
I AGREE
KEEP THE FLOOR OF THE FIRING BOOTH COMPLETELY CLEAR - PLACE CASES AND OTHER ITEMS ON THE SHELF OR THE FLOOR AT THE REAR OF THE RANGE. *
I AGREE
DO NOT BRING FOOD, DRINK, OR TOBACCO INTO THE RANGE AT ANY TIME. *
I AGREE
DO NOT FIRE STEEL CORE AMMO, TRACERS, BIRDSHOT, OR BUCKSHOT. *
I AGREE
IF YOU FAIL TO FOLLOW THESE RULES, OR DO ANYTHING AT ALL THAT WE JUDGE TO BE UNSAFE, WE MAY IMMEDIATELY REMOVE YOU FROM THE RANGE, AND MAY ALSO PERMANENTLY REVOKE YOUR RANGE PRIVILEGES. *
I UNDERSTAND AND AGREE
YOU ARE RESPONSIBLE FOR ANY DAMAGE YOU CAUSE TO THE RANGE OR ASSOCIATED EQUIPMENT. YOU ARE REQUIRED TO PAY THE COST OF REPAIR, AS DETERMINED BY US. *
I AGREE TO PAY ANY AND ALL COSTS ASSOCIATED WITH DAMAGE I CAUSE TO THE RANGE OR ASSOCIATED EQUIPMENT
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's FIREARMS EXPERIENCE DISCLOSURE
I rate my previous experience with HANDGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with RIFLES as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
I rate my previous experience with SHOTGUNS as follows:*
NONE
BEGINNER
INTERMEDIATE
EXPERT
Have you ever been adjudicated or administratively determined to be mentally incompetent; been committed to or voluntarily enrolled in an institution for the treatment of mental illness or have a history of mental illness?*
Have you ever been convicted of a FELONY which has not been annulled, or are you otherwise prohibited from handling or possessing a firearm?*
Are you presently the subject of a court order or decree or other governmental order which prohibits you from possessing or handling firearms?*
Are you an unlawful user of or addicted to marijuana, depressants, stimulants, narcotic drugs or any other controlled or illegal substances?*
APPLICANT FURTHER AGREES TO BE HELD FINANCIALLY RESPONSIBLE FOR ANY DAMAGE OR DESTRUCTION TO THE SHOOTING RANGE OR THE PREMISES OF WHICH IT IS PART or for any personal injury or death or property damage resulting, in whole or in part, from the willful conduct or the negligent action or failure to act of the Applicant. Applicant also agrees to adhere to the firearms safety rules and acknowledges having read, understood and signed a copy of Granite State Indoor Range and Gun Shop LLC's Range Rules and agrees to adhere to said Range Rules. ANY DAMAGE DONE TO THE RANGE OR EQUIPMENT WILL RESULT IN A MINIMUM CHARGE OF $25.00 TO SAID APPLICANT UP TO THE FULL COST TO REPAIR OR REPLACE EQUIPMENT AT OUR SOLE DISCRETION. *
I AGREE
I DO NOT AGREE
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such 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 that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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