Fill out your Waivers We’re Here to Help

3634 Interstate 94 Business Loop E.
Dickinson, North Dakota 58601
(701) 300-4511
justin@old10defense.com
Fri - Sun: 8:00 AM - 10:00 PM
Mon - Thu: Currently reserved for LAW ENFORCEMENT / MILITARY. Contact Us For More Details

MINOR PARTICIPANT

Are you bringing any minors to the range with you?(Required)

Add Number Of Minor Participant Details(Required)

Minor’s Name (print)(Required)

Date of Birth:(Required)

Address(Required)

Street Address

Parent’s or Legal Guardian Name: (please print)(Required)

Address(Required)

Street Address

Emergency Contact Number(Required)

Signature(Required)

Minor’s Name (print)

Date of Birth:

Address

Parent’s or Legal Guardian Name: (please print)

Address

Emergency Contact Number

Signature

Minor’s Name (print)

Date of Birth:

Address

Parent’s or Legal Guardian Name: (please print)

Address

Emergency Contact Number

Signature

Inherent Risk and Assumption of Risk: Participant acknowledges and understands that there are inherent risks associated with participation in shooting activities, including but not limited to serious injury, permanent disability, or death caused by the use of firearms, ammunition, and related equipment. Participant further acknowledges that participation in and presence at a shooting range exposes myself to serious and substantial hazards, risks of property damage, physical injury and/or death, and that I have been fully warned with regard to all such risks and hazards. The risks are not restricted to use, but also include being in the general vicinity of the equipment and facilities. I assume all risks and warrant a full and complete disclosure of my abilities that have been made to Old 10 Defense LLC.
Release and Waiver of Liability: Participant and his or her next of kin, heirs, representatives, successors and assigns, unconditionally and irrevocably agree to assume all such hazards and risks and do hereby unconditionally and forever discharge, waive, hold harmless and release, Old 10 Defense LLC and its subsidiaries, affiliates, officers, directors, shareholders, employees, members, agents, representatives, officials, volunteers and other contractors, together with all other parties or entities involved in the design, installation, production, sponsorship, advertising and use of the shooting range (collectively “Releasees”) from any and all claims, demands, losses, costs, liabilities and responsibilities arising from or in any way relating to Participant’s participation in the shooting range operated by Old 10 Defense LLC and waive any claims against Old 10 Defense LLC and Releasees including any claims, demands, losses, costs, liabilities, or other responsibilities that are known or unknown, seen or unforeseen, future or contingent, and whether or not such claims, demands, losses, costs, liabilities, or other responsibilities are occasioned, in whole or in part, by the negligence of Old 10 Defense LLC and/or Releasees, or otherwise.

In consideration of being permitted to enter and use the facilities, I hereby release, discharge, and hold harmless Old 10 Defense LLC its owners, employees, agents, representatives, and affiliates (collectively, the "Released Parties") from any and all claims, actions, damages, or liabilities arising from my participation in activities at the facility, including but not limited to claims for negligence or gross negligence.

Indemnification: Participant hereby indemnifies and shall continue to indemnify and agree to hold harmless Old 10 Defense LLC and Releasees from any and all claims, liabilities, actions, and costs, asserted, made or threatened by any person (including without limitation, any employer, spouse, parent, child or other next of kin) in respect to all injuries and damage, personal injury or death occasioned by Participant by virtue of or arising out of Participant’s participation in Old 10

I agree to indemnify and hold harmless the Released Parties from any claims, actions, damages, or liabilities, including attorney’s fees, arising out of or related to my actions, conduct, or participation at the shooting range.

Compliance with Rules and Instructions: I agree to abide by all rules, regulations, and instructions provided by Old 10 Defense LLC. I understand that failure to comply may result in expulsion from the premises without refund.
Medical Consent: Participant hereby authorizes any medical treatment deemed necessary in the event of any injury while participating in the activity. Participant shall have appropriate insurance or in its absence, agree to pay all costs of medical services that may be incurred on Participant’s behalf. In the event of an emergency, I authorize Old 10 Defense LLC and its staff to obtain necessary medical treatment on my behalf. I agree to bear all costs of such treatment.
Use of Personal Protective Equipment: I acknowledge that I am required to wear appropriate safety equipment, including ear and eye protection, at all times while on the range.
Photography and Media Release: Participant agrees to allow Old 10 Defense LLC to use any media (photos and videos) for promotional purposes without compensation.
Minor Participants (If Applicable): If signing on behalf of a minor, I affirm that I am the minor's parent or legal guardian and agree to the terms of this waiver on their behalf.
Governing Law: This agreement shall be governed by and interpreted in accordance with the laws of the State of North Dakota.
Acknowledgment and Understanding: I have read this waiver in its entirety. I understand its terms and agree to be bound by them. I sign this waiver voluntarily, without any inducement or coercion.

I, the undersigned parent and/or legal guardian, affirm that I am freely signing this agreement. I have read this form and fully understand that by signing this form I am giving up legal rights and/or remedies which may otherwise be available to myself, the minor Participant regarding any losses the minor Participant may sustain as a result of participation at a shooting range, and sign freely and voluntarily without any inducement, assurance or guarantee being made to me and intend my signature to be a complete and unconditional release of all liability. I agree that if any portion is held invalid, the remainder will continue in full legal force and effect.

Step 1 of 4

1. Participant Information

Name:(Required)

Date of Birth:(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Inherent Risk and Assumption of Risk: Participant acknowledges and understands that there are inherent risks associated with participation in shooting activities, including but not limited to serious injury, permanent disability, or death caused by the use of firearms, ammunition, and related equipment. Participant further acknowledges that participation in and presence at a shooting range exposes myself to serious and substantial hazards, risks of property damage, physical injury and/or death, and that I have been fully warned with regard to all such risks and hazards. The risks are not restricted to use, but also include being in the general vicinity of the equipment and facilities. I assume all risks and warrant a full and complete disclosure of my abilities that have been made to Old 10 Defense LLC.
Release and Waiver of Liability: Participant and his or her next of kin, heirs, representatives, successors and assigns, unconditionally and irrevocably agree to assume all such hazards and risks and do hereby unconditionally and forever discharge, waive, hold harmless and release, Old 10 Defense LLC and its subsidiaries, affiliates, officers, directors, shareholders, employees, members, agents, representatives, officials, volunteers and other contractors, together with all other parties or entities involved in the design, installation, production, sponsorship, advertising and use of the shooting range (collectively “Releasees”) from any and all claims, demands, losses, costs, liabilities and responsibilities arising from or in any way relating to Participant’s participation in the shooting range operated by Old 10 Defense LLC and waive any claims against Old 10 Defense LLC and Releasees including any claims, demands, losses, costs, liabilities, or other responsibilities that are known or unknown, seen or unforeseen, future or contingent, and whether or not such claims, demands, losses, costs, liabilities, or other responsibilities are occasioned, in whole or in part, by the negligence of Old 10 Defense LLC and/or Releasees, or otherwise.

In consideration of being permitted to enter and use the facilities, I hereby release, discharge, and hold harmless Old 10 Defense LLC its owners, employees, agents, representatives, and affiliates (collectively, the "Released Parties") from any and all claims, actions, damages, or liabilities arising from my participation in activities at the facility, including but not limited to claims for negligence or gross negligence.

Indemnification: Participant hereby indemnifies and shall continue to indemnify and agree to hold harmless Old 10 Defense LLC and Releasees from any and all claims, liabilities, actions, and costs, asserted, made or threatened by any person (including without limitation, any employer, spouse, parent, child or other next of kin) in respect to all injuries and damage, personal injury or death occasioned by Participant by virtue of or arising out of Participant’s participation in Old 10

Compliance with Rules and Instructions: I agree to abide by all rules, regulations, and instructions provided by Old 10 Defense LLC. I understand that failure to comply may result in expulsion from the premises without refund.
Medical Consent: Participant hereby authorizes any medical treatment deemed necessary in the event of any injury while participating in the activity. Participant shall have appropriate insurance or in its absence, agree to pay all costs of medical services that may be incurred on Participant’s behalf. In the event of an emergency, I authorize Old 10 Defense LLC and its staff to obtain necessary medical treatment on my behalf. I agree to bear all costs of such treatment.
Use of Personal Protective Equipment: I acknowledge that I am required to wear appropriate safety equipment, including ear and eye protection, at all times while on the range.
Photography and Media Release: Participant agrees to allow Old 10 Defense LLC to use any media (photos and videos) for promotional purposes without compensation.
Minor Participants (If Applicable): If signing on behalf of a minor, I affirm that I am the minor's parent or legal guardian and agree to the terms of this waiver on their behalf.
Governing Law: This agreement shall be governed by and interpreted in accordance with the laws of the State of North Dakota.
Acknowledgment and Understanding: I have read this waiver in its entirety. I understand its terms and agree to be bound by them. I sign this waiver voluntarily, without any inducement or coercion.

Fill out your Waivers We’re Here to Help

MINOR PARTICIPANT

1. Participant Information

ADULT PARTICIPANT

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