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TSS Waiver & Firearms Experience & Range Safety Questionnaire & Firearm Rental Questionnaire

WARNING: IF YOU ARE PROHIBITED FROM PURCHASING OR POSSESSING FIREARMS, YOU ARE ALSO PROHIBITED FROM SHOOTING OR HANDLING FIREARMS.  PROHIBITED SHOOTERS WILL BE REPORTED TO STATE AND/OR FEDERAL AUTHORITIES.

Warning: MARIJUANA remains unlawful under Federal law regardless of whether it has been legalized or decriminalized in your home state.  If you are issued a medical marijuana card by your state, you are now PROHIBITED FROM HANDLING, SHOOTING OR OWNING FIREARMS under federal law.

 

I have read and understand the above warnings:

 

Target Shooting Solutions ‐ Waiver

RELEASE OF LIABILITY, ASSUMPTION OF RISK, HOLD HARMLESS, INDEMNITY AGREEMENT, and HEALTH CONDITION DECLARATION

IMPORTANT! This is a binding legal Agreement. Read it CAREFULLY before signing. By signing this Agreement, you are giving up important legal rights.

1. Terms:

a. Claims: any and all legal claims, lawsuits, causes of action, damages, expenses, injuries or costs. This includes, but is not limited to, claims for intentional acts, negligence, nuisance, noise, damage to personal property, or any other legal claim that is cognizable in a state or federal court of law, regardless of whether related to Participant / Guest / Observer’s participation in activities offered by or use of the Property of Target Shooting Solutions.
b. Limitations: physical, mental, emotional or other limitations, disabilities, illnesses, injuries or conditions.
c. Participant / Guest / Observer: Any individual, whether a participant, guest or observer of Target Shooting Solutions, including, but not limited to, participants, guests, observers, event coordinators, range officers, instructors, shooters, or any other person, regardless of age, granted permission to participate in activities, observe activities or use the Property of Target Shooting Solutions.
d. Property: Any property of any form, tangible or intangible, including real estate, buildings, erections, goods, products, firearms, ammunition, or any object owned, whether wholly or partially, by Target Shooting Solutions.
e. Range: any and all shooting, training and practice ranges of Target Shooting Solutions, whether used for lethal, non‐lethal or virtual fire, in any capacity.
f. Target Shooting Solutions or TSS: Target Shooting Solutions, LLC and Liberty Shooting Range, LLC and their respective officers, officials, directors, members, owners, shareholders, employees, representatives, agents, event and stage coordinators and designers, training personnel and directors, firearm and safety instructors, attorneys, insurers, sponsors, and vendors.

2. Agreement to Follow All Safety Rules and Directions: In consideration for me being permitted to be a Participant / Guest / Observer and have use of the Range of the Target Shooting Solutions, including, if applicable, Target Shooting Solutions’ firearms, ammunition or other Property, I hereby AGREE TO FOLLOW AND COMPLY WITHthe written safety rules provided to me with this Agreement, as well as all safety rules, range procedures, and directions, whether written or oral, of Target Shooting Solutions. I further agree that if I observe any safety violation by anyone (employee, participant, guest, observer, or other person), or any unsafe condition of any kind, I will IMMEDIATELY call it to Target Shooting Solutions’ attention by contacting an employee of Target Shooting Solutions. I further agree that Target Shooting Solutions may terminate my use of the Range at any time if I violate any safety rule, procedure or direction, in which case any fees I have paid will not be refunded to me.

3. Non‐Prohibited Person Declaration: By signing this Agreement, I declare, pursuant to 18 PA.C.S. § 4903 – False Swearing, to the best of my knowledge, information and belief that:

a. I am not currently under indictment or information in any court of a crime that could be punished by more than one year in jail.
b. I have never been convicted in any court of a crime that could have been punished by more than one year in jail, regardless of the actual sentence imposed.
c. I am not a fugitive from justice. Copyrighted Target Shooting Solutions, LLC and Prince Law Offices, P.C. – All Rights Reserved.
d. I am not an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance.
e. I am not under the influence of alcohol or any lawful drug that may impair my abilities and I have not consumed any alcohol or lawful drug that may impair my abilities within the last eight (8) hours.
f. I have never been adjudicated mentally defective or committed to a mental institution.
g. I have never been dishonorably discharged from the Armed Forces.
h. I am not subject to a court order restraining me from harassing, stalking, or threatening my child or an intimate partner or child of such a partner.
i. I have never been convicted in any court of a misdemeanor crime of domestic violence.
j. I have never renounced my United States citizenship.
k. I am not an alien illegally in the United States.
l. I have no unlawful, illegal, wrongful or otherwise deceitful intentions in executing this Agreement or in utilizing Target Shooting Solutions’ Range and, if applicable, firearms, ammunition and other Property.

4. Release of My Image and Likeness: I understand that my activities on the Range or on Target Shooting Solutions’ Property may be photographed, videotaped and/or otherwise captured electronically by Target Shooting Solutions. I hereby grant Target Shooting Solutions all rights to use my image and likeness for the purpose of advertising. I understand that use of my image and likeness will be for advertising purposes. This use includes publishing in magazines, advertising, videos, internet websites, social media or other means, as long as it is not altered to show other than actual activities in a way that could be harmful to my character. All publications will be done tastefully and with integrity. I FORFEIT any and all rights to any CLAIMS relating to the use of my image or likeness, as described above. All photographs, videos, or other electronically captured media taken at or in Target Shooting Solutions remain the property of Target Shooting Solutions, and may not be used or reproduced without the express written permission of the President of Target Shooting Solutions.

5. Assumption of Risk: I understand that my being a Participant / Guest / Observer of Target Shooting Solutions or my use of Target Shooting Solutions’ Range, firearms, ammunition and Property involves numerous serious risks, including the risk of death, serious physical injury and property damage. These risks involve, but are not limited to, the risk that I may be injured by: shooting myself or being shot by someone else; being injured by ricochet bullets or fragments, splatter or splashback from targets, target frames or the range backstop; malfunctioning or improperly designed activity and range equipment or props; improper installation or attachment of protective equipment; risk of firearms or ammunition exploding or bursting; non-lethal rounds causing injury, including serious bodily injury and death; risk of my falling, slipping, tripping or stumbling anywhere in Target Shooting Solutions’ Range or on its Property; risk of my suffering serious eye injury or blindness, hearing loss or deafness, brain damage, lead poisoning, broken bones, paralysis, sprains, strains, and other injuries resulting from use of Target Shooting Solutions’ Range, Property and participation in or observation of the associated activities; risks of emotional and psychological injury; and other risks too varied and numerous to specify. By willingly, knowingly and voluntarily being a Participant / Guest / Observer of Target Shooting Solutions, I hereby ASSUME ALL RISKS involved, including EVEN THOSE, WHICH MAY BE CAUSED BY THE NEGLIGENCE OR CLAIMED NEGLIGENCE OF TARGET SHOOTING SOLUTIONS.

6. Release: I further agree to RELEASE TARGET SHOOTING SOLUTIONS from LIABILITY for any and all CLAIMS which may result from, or are in any way related to, Target Shooting Solutions or its Property. I agree to RELEASE Target Shooting Solutions from LIABILITY Copyrighted Target Shooting Solutions, LLC and Prince Law Offices, P.C. – All Rights Reserved. for any and all CLAIMS, even if caused by the NEGLIGENCE or CLAIMED NEGLIGENCE of Target Shooting Solutions.

7. Indemnity Agreement: I further agree to INDEMNIFY and DEFEND Target Shooting Solutions AND HOLD Target Shooting Solutions HARMLESS from any CLAIMS, whether brought by or on behalf of me, or brought by another as a result of my actual or claimed negligence or other improper conduct.

8. Health Condition Declaration:I hereby confirm that I AM IN GOOD HEALTH, and have no Limitations that would or might make it unsafe for me to be a Participant / Guest / Observer of the Target Shooting Solutions or use its Property. I agree to inform Target Shooting Solutions in writing below, before becoming a Participant / Guest / Observer or using its Property and Ranges, of any Limitations, physical or otherwise, which would or might make it unsafe or inadvisable for me to perform any particular types of activities or exercises. To the extent I develop or become aware of any such Limitations while being a Participant / Guest / Observer of Target Shooting Solutions or otherwise using Target Shooting Solution’s Property and Ranges, or feel that any of Target Shooting Solutions’ activities or programs are ones in which I cannot safely participate, I agree that I will immediately call this situation to the attention of Target Shooting Solutions and that I WILL NOT PERFORM ANY ACTIVITY OR PROGRAM WHICH I FEEL IS UNSAFE FOR ME TO PERFORM, OR WHICH IS BEYOND MY PHYSICAL OR MENTAL CAPABILITIES, SKILL LEVEL, or LEVEL OF TRAINING. I understand that my use of Target Shooting Solutions’ range is voluntary, and there is no requirement that I perform all, or any, of Target Shooting Solutions’ activities or programs. My current known Limitations (including the use of any prescription or non‐prescription drugs or other substances) that might affect my ability to participate fully and safely in the activities, are as follows:

9. General Conditions:

a. To the extent that any provision of this Agreement is held to conflict with or be unenforceable under applicable law, I agree that this Agreement shall be modified by the Court to the least extent possible to render it enforceable, and shall be enforced as so modified.

b. I declare that this Agreement and, if applicable, my Membership Application contain the total agreement and understanding between me and Target Shooting Solutions with regard to the subject matter hereof, that there exist no other promises, representations, terms, conditions, agreements or courses of dealing not contained herein or within the Membership Application. I further declare and agree that, in any event, this Agreement supersedes any such promises, agreements, etc. in the event they ever occurred. This Agreement may not be amended or changed except in writing signed by the President of the Target Shooting Solutions, Alexander Toto.

c. I declare that my use of Target Shooting Solutions’ Range is purely voluntary, and that I am compelled neither to use Target Shooting Solutions’ Range nor to execute this Agreement.

WHEREFORE, I HEREBY ACKNOWLEDGE AND AGREE BY MY SIGNATURE BELOW that I have read and understood this Agreement, including the within (1) Terms, (2) Agreement to Follow All Safety Rules and Direction, (3) Non‐Prohibited Person Declaration, (4) Release of My Image and Likeness, (5) Assumption of Risk, (6) Release, (7) Indemnity Agreement, (8) Health Condition Declaration and (9) General Conditions, and that by signing it, I expressly intend to be legally bound, as well as to bind my estate, heirs, successors and assigns. I further agree that this Agreement shall remain in force indefinitely.

Date: April 25, 2024

Target Shooting Solutions – Range Use Declaration

1. Terms:

a. Property: Any property of any form, tangible or intangible, including real estate, buildings, erections, goods, products, firearms, ammunition, or any object owned, whether wholly or partially, by Target Shooting Solutions.
b. Range: any and all shooting, training and practice ranges of Target Shooting Solutions, whether used for lethal, non‐lethal or virtual fire, in any capacity.
c. Target Shooting Solutions or TSS: Target Shooting Solutions, LLC and Liberty Shooting Range, LLC and their respective officers, officials, directors, members, owners, shareholders, employees, representatives, agents, event and stage coordinators and designers, training personnel and directors, firearm and safety instructors, attorneys, insurers, sponsors, and vendors.
d. Target Shooting Solutions Waiver: The Target Shooting Solutions Release of Liability, Assumption of Risk, Hold Harmless, Indemnity Agreement, and Health Condition Declaration.

2. Reaffirmation of Release of Liability, Assumption of Risk, Hold Harmless, Indemnity Agreement, and Health Condition Declaration: I hereby acknowledge having previously executed the Target Shooting Solutions’ Waiver and reaffirm all statements and agreements made therein.

3. Agreement to Follow All Safety Rules, Regulations and Directions: In consideration for me being permitted access to and use of the Range of Target Shooting Solutions, including, if applicable, Target Shooting Solutions’ firearms, ammunition or other Property, I hereby AGREE TO FOLLOW AND COMPLY WITH the written safety rules, regulations and range etiquette provisions provided to me with this Declaration, as well as all safety rules, range procedures, and directions, whether written or oral, of Target Shooting Solutions. I further agree that Target Shooting Solutions may terminate my use of the Range at any time if I violate any safety rule, regulation, procedure or direction, in which case any fees I have paid will not be refunded to me.

4. Non‐Prohibited Person and Safety Declaration: By signing this Declaration, in addition to my declarations in the Target Shooting Solutions’ Waiver, I declare, pursuant to 18 PA.C.S. § 4903 – False Swearing, that:

a. I am not currently prohibited under state or federal law from possessing and utilizing firearms or ammunition.
b. I am not under the influence of alcohol or any drug and I have not consumed any alcohol or drug within the last eight (8) hours.
c. I have no unlawful, illegal, wrongful or otherwise deceitful intentions in executing this Declaration or in utilizing Target Shooting Solutions’ Range and, if applicable, firearms, ammunition and other Property.

WHEREFORE, I HEREBY ACKNOWLEDGE AND AGREE BY MY SIGNATURE BELOW that I have read and understood this Declaration, and that by signing it, I expressly intend to be legally bound, as well as to bind my estate, heirs, successors and assigns.


Date: April 25, 2024

 

FIREARMS EXPERIENCE & RANGE SAFETY QUESTIONNAIRE

EVERYONE who wishes to shoot in this facility, whether using their own or a Target Shooting Solutions, LLC rental firearm MUST completely fill out this form. All information supplied will be kept strictly confidential, not distributed or made available to other for any purpose, unless required by law, and is for the sole use of Target Shooting Solutions, LLC and Liberty Range, LLC to properly identify the user and document their previous firearm experience. This is done to best ensure the safety of all range users.

Date: April 25, 2024

Please select who will be shooting
AdultMinor
Continue
First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

First and last name must match driver's license exactly.


My current known Limitations (including the use of any prescription or non‐prescription drugs or other substances) that might affect my ability to participate fully and safely in the activities, are as follows: If NONE, leave blank

OCCUPATION

I WOULD RATE MY PREVIOUS EXPERIENCE WITH FIREARMS AS: 

HANDGUN*
RIFLE*
SHOTGUN*
ARE YOU PROHIBITED UNDER STATE OR FEDERAL LAW FROM POSSESSING, USING, OR PURCHASING FIREARMS AND AMMMUNITION?*
No
Yes
DO YOU HAVE ANY UNLAWFUL, ILLEGAL, WRONGFUL OR OTHERWISE DECEITFUL INTENTIONS OR PURPOSES IN RENTINGTHIS FIREARM?*
No
Yes

Applicant hereby acknowledges having previously executed Target Shooting Solutions Release of Liability, Assumption of Risk, Hold Harmless, Indemnity Agreement, and Health Condition Declaration and reaffirms all statements and agreements made therein, including, but not limited to, releasing Target Shooting Solutions, LLC and Liberty Shooting Range, LLC from any and all liability for personal Injury or property damage arising out of the use of the equipment and/or facilities of Target Shooting Solutions, LLC and Liberty Shooting Range, LLC and agree to hold free, clear, and harmless for and indemnify Target Shooting Solutions, LLC and Liberty Shooting Range, LLC from responsibility for any and all claims and demands for personal injury or property damage arising out of such use. 

I agree to be held financially responsible for any destruction or damage to the range, range equipment, or firearm beyond normal wear and tear.

Target Shooting Solutions Firearm Rental Questionnaire

You must be 18 years old to rent a firearm and have valid ID.

Anyone suspected of alcohol or drug use will not be allowed on the range.


Telephone #:
Do you have firearm experience?*
No
Yes
If yes, with what type of firearm: *
Pistol
Rifle
Shotgun
What is your level of experience?*
Beginner
Novice
Expert

Other, please specify:

Please list any firearm training:

All ammo used in our rental guns must be purchased from Target Shooting  Solutions, LLC. 

The undersigned acknowledges having read all range rules and understands them. By  signing below, you declare that you understand the proper and safe use of the firearm you have rented. You also agree that any and all injuries that occur are at your own  risk and acknowledge having previously executed the Target Shooting  Solutions' Release of Liability, Assumption of Risk, Hold Harmless, Indemnity Agreement, and Health Condition Declaration and reaffirm all  statements and agreements made therein 

Target Shooting Solutions, LLC and its employees are not liable for any injury. The undersigned is responsible for any misuse or damage of range equipment and the firearm.

First Participant's Signature*
Participant'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*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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*
First and last name must match driver's license exactly
By signing below, you are agreeing to the foregoing and hereby release and hold Target  Shooting Solutions harmless for any CLAIMS on behalf of yourself and/or the Participant /  Guest / Observer, as if you are the Participant / Guest / Observer:


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*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

First and last name must match driver's license exactly.


My current known Limitations (including the use of any prescription or non‐prescription drugs or other substances) that might affect my ability to participate fully and safely in the activities, are as follows: If NONE, leave blank

OCCUPATION

I WOULD RATE MY PREVIOUS EXPERIENCE WITH FIREARMS AS: 

HANDGUN*
RIFLE*
SHOTGUN*
ARE YOU PROHIBITED UNDER STATE OR FEDERAL LAW FROM POSSESSING, USING, OR PURCHASING FIREARMS AND AMMMUNITION?*
No
Yes
DO YOU HAVE ANY UNLAWFUL, ILLEGAL, WRONGFUL OR OTHERWISE DECEITFUL INTENTIONS OR PURPOSES IN RENTINGTHIS FIREARM?*
No
Yes

Applicant hereby acknowledges having previously executed Target Shooting Solutions Release of Liability, Assumption of Risk, Hold Harmless, Indemnity Agreement, and Health Condition Declaration and reaffirms all statements and agreements made therein, including, but not limited to, releasing Target Shooting Solutions, LLC and Liberty Shooting Range, LLC from any and all liability for personal Injury or property damage arising out of the use of the equipment and/or facilities of Target Shooting Solutions, LLC and Liberty Shooting Range, LLC and agree to hold free, clear, and harmless for and indemnify Target Shooting Solutions, LLC and Liberty Shooting Range, LLC from responsibility for any and all claims and demands for personal injury or property damage arising out of such use. 

I agree to be held financially responsible for any destruction or damage to the range, range equipment, or firearm beyond normal wear and tear.

Target Shooting Solutions Firearm Rental Questionnaire

You must be 18 years old to rent a firearm and have valid ID.

Anyone suspected of alcohol or drug use will not be allowed on the range.


Telephone #:
Do you have firearm experience?*
No
Yes
If yes, with what type of firearm: *
Pistol
Rifle
Shotgun
What is your level of experience?*
Beginner
Novice
Expert

Other, please specify:

Please list any firearm training:

All ammo used in our rental guns must be purchased from Target Shooting  Solutions, LLC. 

The undersigned acknowledges having read all range rules and understands them. By  signing below, you declare that you understand the proper and safe use of the firearm you have rented. You also agree that any and all injuries that occur are at your own  risk and acknowledge having previously executed the Target Shooting  Solutions' Release of Liability, Assumption of Risk, Hold Harmless, Indemnity Agreement, and Health Condition Declaration and reaffirm all  statements and agreements made therein 

Target Shooting Solutions, LLC and its employees are not liable for any injury. The undersigned is responsible for any misuse or damage of range equipment and the firearm.

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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