NOTICE: THIS IS A LEGALLY BINDING AGREEMENT. BY SIGNING THIS AGREEMENT YOU GIVE UP YOUR RIGHT TO
BRING A COURT ACTION TO RECOVER COMPENSATION OR OBTAIN ANY OTHER REMEDY FOR INJURIES TO
YOURSELF OR YOUR PROPERTY ARISING OUT OF YOUR USE OF FACILITIES OF THE HOLLYWOOD RIFLE &
PISTOL CLUB, NOW OR ANY TIME IN THE FUTURE.
I, the undersigned user, hereby acknowledge and agree that target shooting, the use of firearms and the use of the
facilities of Hollywood Rifle & Pistol (“HRPC”) may be dangerous and may involve the risk of serious bodily injury. I have
full knowledge of the nature and extent of all of the risks associated with the use of the HRPC facilities, including, but not
limited to: (a) all manner of injury, including, but not limited to death and/or paralysis arising from target shooting, the
use of firearms or their discharge; (b) injuries resulting from intentional or inadvertent discharge of firearms by myself or
others using the HRPC facilities, including loss of hearing, burns, blindness, or other injury; (c) injuries resulting from
explosions, contact with projectiles and hardware; and (d) failure or misuse of any equipment, whether owned and
maintained by HRPC or otherwise. I have been advised that the use of vision and hearing protection are required at all
times when present on the facilities of HRPC. If I choose not to use such protection, I agree to assume the additional
risks associated with lack of their use. I acknowledge that the above list is not inclusive of all the possible risks
associated with my use of HRPC and that the above list in no way limits the extent of this Waiver of
Liability/Indemnification Agreement and Covenant Not to Sue.
In consideration of my use of HRPC, I agree to release and, on behalf of myself, my heirs, representatives, executors,
administrators and assigns (the “Releasor”), & HEREBY DO RELEASE HRPC, it’s members, owners, shareholders,
officers, directors, employees and agents (the “HRPC Releasees”) from any cause of action, claim, or demand of any
nature whatsoever (except for their gross negligence or willful misconduct) which the Releasors may now have or have
in the future against the HRPC Releasees on account of personal injury, property damage, death or accident of any
kind, arising out of or in any way related to my use of HRPC facilities, whether that use is supervised or unsupervised,
and however the injury or damage is caused, including but not limited to the negligence of the HRPC Releasees. I
further covenant that I shall bring no civil action against the HRPC Releasees based upon any of the foregoing. I
understand that I will be solely responsible for any loss or damage including, but not limited to, death or paralysis, that I
may sustain while using HRPC and that by signing this Agreement, I am relieving the HRPC Releasees of any and all
liability for such loss, damage or death (other than as a result of their gross negligence or intentional misconduct).
I do hereby further agree to INDEMNIFY AND HOLD HARMLESS the HRPC Releasees from any and all causes of
action, claims, demands, losses or costs of any nature whatsoever (except for those resulting from the gross negligence
or willful misconduct of the HRPC Releasees) arising out of or in any way relating to my use of HRPC (excluding any
violation of environmental laws). I further certify that I am in good health and that I have no physical or mental limitations
that would preclude my safe use of HRPC facilities.
I acknowledge that the foregoing agreement is intended to be as broad and inclusive as permitted by the law of the
State of Florida and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding,
continue in full force and effect. I understand that the terms of this agreement are legally binding and that I am signing
this agreement, after having carefully read it of my own free will.
IN WITNESS WHEREOF, I have read and executed this agreement this ____ day of______________,20____
User Signature: _____________________ User FULL Name (print): ____________________________________
*Parent/Guardian Signature: Parent /Guardian FULL Name/Relationship (print):
___________________________________ ________________________________________________________
(*Under age 18 requires approval of Parent/Guardian)
Emergency Contact Name: _______________________________
Phone: ________________________________
Date Adopted: June 17, 2008